GUIDELINES ON PSYCHOSOCIAL RISK ASSESSMENT AND MANAGEMENT AT WORKPLACE (PRISMA) 2024 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024 Copyright All Rights Reserved. Department of Occupational Safety and Health 2024 All rights reserved. No part of this publication may be reproduced, or transmitted in any form of by any means electronic or mechanical including photocopying, recording, or any information storage and retrieval system without any permission in writing form the Director General of Occupational Safety and Health. ISBN PRINTED BY THE DEPARTMENT OF OCCUPATIONAL SAFETY AND HEALTH 01: Preface These guidelines may be cited as the Guidelines on Psychosocial Risk Assessment and Management at the Workplace. The purpose of these guidelines is to guide employers in screening and assessment of psychosocial risks in the workplace and recommend actions to be taken by employers in the control of psychosocial risks in the workplace. Governments and employers have a responsibility to uphold that right by providing work that simultaneously prevents workers from experiencing excessive stress and mental health risks, protects and promotes workers’ mental health and well-being and supports people to fully and effectively participate in the workforce, free from stigma, discrimination or abuse. Ir. Mohd Hatta Bin Zakaria Director General, Department of Occupational Safety and Health Safe, healthy, and inclusive workplaces not only enhance mental and physical health but likely also reduce absenteeism, improve work performance and productivity, boost staff morale and motivation, and minimize conflict between colleagues. These guidelines provide recommendations on interventions that can be implemented to better prevent, protect and promote, and support the mental health of workers. It highlights the importance of organizational interventions, manager and worker training, and interventions for individuals. These guidelines mark a milestone in leveraging workplaces as a platform for action, providing a framework for the evidence-based action required to ensure effective prevention, promotion, and support for mental health at work. We encourage industries and all stakeholders to use and implement these guidelines as an effective tool for securing safe, healthy, and inclusive workplaces that promote and protect mental health. With these Guidelines, which are practical and comprehensive, it is anticipated that these guidelines will be carried out effectively for early detection or prevention of occupational disease related to psychososial risk factors which thereby increasing the organizational productivity and towards healthy working population. 1 02: Acknowledgments These guidelines have been prepared through the joint effort of the Department of Occupational Safety and Health (DOSH), representatives from government agencies, higher learning institutions, and professionals. The Department would particularly like to thank the following organizations and distinguished individuals for their most valuable contributions during the drafting of the guidelines. The Technical Committee for the Guidelines on Psychosocial Risk Assessment and Management at the Workplace consists of representatives from the following organisations: Tecnical Commitee No. Name Organizations 1. Dr. Ahmad Fitri Bin Abdullah Hair Department of Occupational Safety and Health 2. Dr. Rajinderjit Singh Hullon Department of Occupational Safety and Health 3. Dr. Ahmad Faiz Azhari Noor Department of Occupational Safety and Health 4. Dr. Mohd Fizal Izwan Abd Kadir Department of Occupational Safety and Health 5. Dr. Santhanamohan Nagesperam Department of Occupational Safety and Health 6. Dr. Muhd Zafran Bin Shamsudin Department of Occupational Safety and Health 7. Dr. Nurashikin Binti Ibrahim Pusat Kecemerlangan Kesihatan Mental Kebangsaan 8. Dr. Nur Sakinah Binti Ahmad Pusat Kecemerlangan Kesihatan Mental Kebangsaan 9. Prof. Madya Dr. Hanizah Binti Mohd Yusoff Universiti Kebangsaan Malaysia 10. Prof. Madya Dr. Irniza Binti Rasdi Universiti Putra Malaysia 11. Dr. Mohd Faiz Bin Md Tahir Universiti Islam Antarabangsa 12. Dr. Nik Khairol Reza Bin Md Yazin Kementerian Kesihatan Malaysia 13. Profesor Dr. Victor Hoe Abdullah Academy of Occupational & Environmental Medicine, Malaysia (AOEMM) 14. Dr. Anza Binti Elias Academy of Occupational & Environmental Medicine, Malaysia (AOEMM) 15. Dr. Zulkifli M. Yunus PETRONAS 16. Dr. Ahmad Syarifuddin Bin Ramlan PERKESO 17. Dr. Mohamad Ghazali Bin Masuri Universiti Teknologi MARA 18. Prof. Madya Ts. Dr. Mohd Shukri Bin Mohd. Aris Universiti Teknologi MARA 19. Dr. Ismaniza Binti Ismail Universiti Teknologi MARA 20. Dr. Khairil Anuar Bin Md. Isa Universiti Teknologi MARA 2 03: Table Of Contents 01 02 03 04 05 Preface __________________1 Acknowledgment __________________2 Table of Contents __________________3 List of Abbreviations __________________4 Terminology & Definitions __________________5 06 Introduction to Psychosocial Risk at __________________6 the Workplace 07 Mental Health at Workplace 08 Psychososial Risk at __________________9 the Workplace __________________8 08.1: Healthy Workplace 08.2: Psychososial Risk at the Workplace 08.3: Work Content vs Work Context 08.4: Psychososial Risk Factors 08.5: Psychosocial Hazards - Economic Impact & Productivity 08.6: Work Stress 09 10 Gap Analysis _________________15 Standard Legislation _________________16 10.1: Employment Psychosocial Legislation & Standards 10.1: Employment Psychosocial Legislation & Standards 10.1.1: ISO45003:2021 Occupational Health and Safety Management 10.1.2: Occupational Safety and Health Act (Amendment 2022) 11 Introduction to PRisMA _______________19 11.1: Goal 11.2: Objectives 11.3: PRisMA Procedures 11.4: PRisMA Approach 11.4.1: Proactive Approach 11.4.1: Reactive Approach 3 03: Table Of Contents 11 Introduction to PRisMA _______________19 11.5: Step I: Risk Assessment 11.6: Step II: Risk Management 11.7: Screening Tools 11.8: Employer's Roles and Responsibilities 11.9: PRisMA Trained Person 11.10: Employees Roles and Responsibilities 11.11: Scope 11.12: Application 11.13: Reporting 11.14: Re-assessment 11.15: Limitation 12 _______________25 Risk Assessment 12.1: Risk Assessment Process 13 _______________27 Risk Management 13.1: Risk Management Process 14 Scenarios of Workplace Psychosocial Issues _______________33 14.1: Case 1 – Workplace Score (Proactive Approach) 14.2: Case 2 – High Risk Score (Reactive Approach) 14.3: Case 3 – Existing Risk Management Program 15 Appendix - List of Forms & Information _______________45 Appendix 1: PRisMA Form 1 – Likelihood of Environment & Occupational Exposure Scale Towards Psychosocial Risk at the Workplace (LEO26) Appendix 2: PRisMA Form 2 – Employer Practice Checklist 23 (EPC23) Appendix 3: PRisMA Form 3 – Workplace Psychosocial Risk Reporting Appendix 4: MSIC 2008 Industry Reference List Appendix 5: First Schedule - Act A1648 Appendix 6: List of Contributors 4 04: List of Abbreviations DOSH Department of Occupational Safety and Health ILO International Labour Organization LEO26 Likelihood of Environment & Occupational Exposure Scale towards Psychosocial Risk at the Workplace MOH Ministry of Health Malaysia PRisMA Psychosocial Risk Assessment and Management in the Workplace PTP PRisMA Trained Person WHO World Health Organization OSH Occupational Safety and Health EPC Employer Practice Checklist JC Job Control WD Work Demand JS Job Support 5 05: List of Figures & Tables Figure 1: The Healthy Workplace Model by WHO: Processes, Influences and Core Principles. _________________11 Figure 2: The Impact of Unhealthy and Unsafe Workplaces on Employer Achievement. _________________14 Figure 3: American Institute of Stress Traumatic Accident Model (Kamp, 1994) _________________15 Figure 4: Flowchart of Psychosocial Risk Assessment and Management at the Workplace (PRisMA) _________________20 Table 1: LEO26 Individual Risk Score Table _________________25 Table 2: LEO26 Cumulative Risk Score Table _________________26 Table 3: Risk Management Based on LEO26 Components and EPC23 Table _________________28 Table 4: (EPC23) _________________30 Employer Practice Checklist Table 5: Collective Measures Managing Psychosocial Risk at Work Table 6 _________________32 06: Terminology & Definitions Fairness Refers to treating individuals equitably, justly, and without discrimination. Job Control The amount of discretion and control an individual has over their job’s specific tasks and processe. Job Matching The process of aligning an individual's skills, qualifications, and attributes with the requirements and demands of a specific job. Job Support The assistance, guidance, or resources provided to individuals to help them succeed in their employment or career. Occupational Health Doctor A medical practitioner registered under the Medical Act 1971 with a valid annual practicing certificate, who is also registered with the Director General and possess a valid occupational health doctor's certificate Social Support The assistance, care, and encouragement provided by others in times of need. Training and Education Training and education are essential components of personal and professional development. They involve acquiring knowledge, skills, and competencies through structured learning experiences to enhance individual capabilities and performance. Transparency Refers to openness, visibility, and the free flow of information. Workload The amount of work that individuals are expected to complete within a specific period Work Context The environment, conditions, or circumstances in which work is performed. Work Demand The physical, cognitive, and emotional requirements of a job or task that individuals are expected to fulfill. Working Environment A positive and healthy working environment is crucial for the well-being, productivity, and satisfaction of employees. It encompasses various factors that contributing supportive, inclusive, and engaging workplace. Employer Immediate employer or the principal employer or both 7 06: Terminology & Definitions Employee A person who is employed for wages under a contract of service on or in connection with the work of an industry to which OSHA 1994 applies and — (a) who is directly employed by the principal employer on any work of, or incidental or preliminary to or connected with the work of, the industry, whether such work is done by the employee at the place of work or elsewhere; (b) who is employed by or through an immediate employer at the place of work of the industry or under the supervision of the principal employer or his agent on work which is ordinarily part of the work of the industry or which is preliminary to the work carried on in or incidental to the purpose of the industry; or (c) whose services are temporarily lent or let on hire to the principal employer by the person with whom the person whose services are so lent or let on hire has entered into a contract of service Occupational Therapist An occupational therapist is a healthcare professional who specializes in helping individuals develop, recover, or maintain the skills needed for daily living and working. Occupational therapists work with people of all ages who may have physical, mental, developmental, or emotional challenges that affect their ability to engage in meaningful activities or occupations. Psychosocial Rehabilitation Psychosocial rehabilitation is a holistic approach to supporting individuals with mental health conditions in their recovery process. It focuses on helping people develop the necessary skills, strategies, and support networks to live fulfilling and meaningful lives despite the challenges posed by their mental health conditions. The primary goal of psychosocial rehabilitation is to promote recovery, empowerment, and community integration. Work Demand Work demand refers to the requirements, expectations, or tasks placed on individuals within a work environment. These demands can come from various sources, including job responsibilities, organizational goals, deadlines, and performance expectations. Work demand encompasses both quantitative and qualitative aspects of work, including the volume of tasks, complexity, pace, and intensity. 8 07: Mental Health at Workplace 07.1: Introduction Mental health in the workplace refers to the psychological well-being of employees within their work environment. It encompasses various factors, including stress levels, emotional resilience, work-life balance, job satisfaction, and the support systems available to address mental health challenges. The World Health Organization (WHO) expresses it as mental health that is: “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” Depression and anxiety disorders are common mental disorders that affect our ability to work and work productively. Worldwide, more than 300 million people suffer from depression, which is a leading cause of disability. More than 260 million live with an anxiety disorder, and many of them have both problems (WHO, 2017). These workplace mental health issues are indeed very important. In relation to that, effective planning and action needs to be thought about by the authorities. Promoting mental health in the workplace is essential for creating a supportive and productive work environment and for preventing issues such as burnout, anxiety, depression, and other mental health disorders. By prioritizing mental health in the workplace and implementing strategies to support employee well-being, organizations can create a healthier, more resilient workforce and improve overall workers morale and productivity. 9 08: Psychosocial Risk at the Workplace Psychosocial risk is a combination of the likelihood of occurrence of exposure to work-related hazard(s) of a psychosocial nature and the severity of injury and ill health that can be caused by these hazards (ISO45003: 2021). Despite the high prevalence of this issue in Malaysia, psychosocial health literacy remains low (Munawar et al., 2021) and minimally discussed, leading to the stigma around psychosocial health and treatment gaps. Exposure to factors of work activities and the workplace environment, along with the knowledge, access to resources, and long hours spent at work, may lead to disturbances to psychosocial health (Samar & Perveen, 2021; Loo & Furnham, 2012; Brown, Harris, & Russell, 2010; Hassan et al., 2018). A mentally healthy person will respond positively in many situations and act with sanity and maturity of mind. However, when a worker has psychosocial health issues; it does not only cause acute and chronic damage to the body systems and organs, but also incurs a huge cost to the employer in terms of workers’ health, absenteeism and lower performance (ILO, 2023), especially if not contained early. Therefore, it is critical for employers to take action towards this issue. 08.1: Healthy Workplace A healthy workplace does not only focus on the physical, chemical, biological, and ergonomic work environment, but spans across lifestyle, psychosocial factors, work organization, and workplace culture, which can have a profound effect on the health of workers. The WHO Regional Office for the Western Pacific defines a healthy workplace as follows: “A healthy workplace is one where everyone works together to achieve an agreed vision for the health and well-being of employees and the surrounding community. It provides all members of the workforce with physical, psychological, social and organizational conditions that protect and promote health and safety. It allows managers and employees to increase control over their own health and to improve it, and become more energetic, positive and satisfied.” (Regional Guidelines for the Development of Healthy Workplaces. World Health Organization, Regional Office for the Western Pacific, 1999). 08.2: Psychosocial Risks at the Workplace In a 2022 report by the World Health Organisation (WHO), it is estimated that 15% of working-aged adults had a mental disorder in 2019. Malaysians are at risk of high stress levels, anxiety, depression and another commonly overlooked syndrome; burnout, taking a major toll on their physical and mental well-being (Shaare et al., 2022). 10 08: Psychosocial Risk at the Workplace All these are identified through the imbalance of the worker's biological factors and has an impact on psychological factors (thoughts, emotions, and behavior), and social factors (socio-environment and safety culture at work). According to the International Labor Organization (ILO), dangerous physical and emotional reactions are caused by a mismatch between demands and the individual's resources and ability to cope with those demands. Work-related stress is determined by work organization, work design and employee relations that occur when job demands are inappropriate or exceed the individual's capabilities, leading to stress. It is no exaggeration to say that the wealth of an organization depends on the health of its employees. Employees are a very valuable asset to every organization. Healthy employees will contribute to the productivity and wealth of the employer. Therefore, employers must always take care and ensure that the health conditions of their employees are in the best condition. In line with this WHO model, PRisMA provides a framework that can be adapted to various Malaysian workplaces and work cultures. This is parallel with the philosophy of OSHA 1994 in which responsibility for safety and health in the workplace lies with those who create the risks (employers) and those who work with the risks (employees). Figure 1 below shows the basic principles in terms of morals and ethics emphasize that it is important for employers and a workplace to avoid any damage/pain to employees, at the same time emphasizing the psychosocial environment of the workplace as one of the important components in this model. Figure 1: The Healthy Workplace Model by WHO: Processes, Influences and Core Principles. 11 08: Psychosocial Risk at the Workplace 08.3: Work Content vs Work Context Cox identified ten types of stressful work characteristics (psychosocial hazards), which are divided into two groups: "work content" and "work context". Cox (1993); Cox, Griffiths, Rial-Gonzalez (2000) – Appendix 3. Basically, employees are in a state of stress or feel depressed when they cannot cope with the pressure at work. In the long term, this condition is also associated with an impact on anxiety and depression. According to the International Labor Organization (ILO), this matter is divided into two (2) main causes: a. Work Content Work content refers to psychosocial hazards related to work conditions and work organization. Quantitative workload (amount of work to be done) and qualitative workload (difficulty of work) are associated with stress. The workload should be considered in relation to the work area, such as the speed at which the work should be completed, as well as the nature and handling requirements of the system itself or the machine. Work content includes several harmful aspects, such as low job value, low skill utilization, lack of task variety and such. Work content uncertainty can be expressed in different ways, including lack of performance feedback, uncertainty about desired behavior (role ambiguity), and uncertainty about the future (job security). Poor physical working conditions and environments, including workplace layout and exposure to hazardous agents, can influence workers' stress experiences and their psychological and physical health WHO (2010). b. Work Contrast Work context refers to psychosocial hazards in the organization of work and labour relations, such as organizational culture and functioning and interpersonal relationships at work. Aspects of organizational culture and function are very important including organizations that influence task performance, career development. For example, several organizational factors have been identified as contributing to the occurrence of bullying, monotonous work, low levels of control, role conflict ambiguity, excessive workload, poor conflict management, and organizational change WHO (2010); Examples of collective action in the workplace to manage stress as recommended by the ILO (2012b). 08.4: Psychososial Risk Factors Workplace factors that can cause stress are called psychosocial hazards. Psychosocial factor (hazard) is defined as "the interaction between the work environment, job content, organizational conditions and workers' abilities, needs, culture, additional personal work considerations that may, through perception and experience, affect health, work performance and job satisfaction" (ILO, 1984). 12 08: Psychosocial Risk at the Workplace This definition emphasizes the dynamic interaction between the work environment and human factors. The negative interaction between work conditions and human factors can cause emotional disturbances, behavioural problems, biochemical and neuro-hormonal changes, which pose an additional risk of mental or physical illness. On the other hand, when work conditions and human factors are balanced, work creates feelings of mastery and selfconfidence; increases motivation, work ability and satisfaction; and improves health. This term has evolved over the years, from stress to several other terms, among which are psychosocial stress factors, psychosocial hazards or psychosocial risks. The terms "psychosocial hazard" and "psychosocial risk" are sometimes also used interchangeably in the scientific literature. In using these guidelines, employers are encouraged to refer to the analysis of hint information that contributes to the cause of occupational psychosocial issues as below: a. Absence data due to illness (absenteeism); b. Sickness absence data; c. Staff turnover rates; d. Exit interviews; e. Number of referrals to occupational health; and f. Information from existing staff discussions. 08.5: Psychosocial Hazards - Economic Impact & Productivity According to a report issued by the WHO, psychosocial risk can be linked to injury either directly or indirectly. Employers should be aware when employees do not have sufficient influence over hazardous conditions in the workplace, they lack control in reducing threats to life and limb. Therefore, lack of control can directly contribute to injury. According to the WHO, workers who experience psychosocial hazards may experience the following symptoms: • sleep problems • drink excessively • feel stressed • feeling anxious, restless, and nervous • feeling angry and reckless (often due to a sense of unfairness or injustice) When these symptoms occur, more serious effects may arise such as: • momentarily disturbed feeling • make dangerous errors in judgment • limbs tend to stretch and sprain • fail in activities that require eye-hand-foot coordination. 13 08: Psychosocial Risk at the Workplace Economic wise, neglecting psychosocial health of workers also affects the productivity, efficiency and output of organizations. This can manifest in various forms, including absenteeism (habitual absence from work) and presenteeism (going to work despite being sick), and also higher accident and injury rates. The following diagrams show how a business can fail or be disrupted in terms of achievement if the workplace fails to be a healthy and safe place for its employees. Figure 2: The Impact of Unhealthy and Unsafe Workplaces on Employer Achievement Globally, about 12 billion work days are lost annually to depression and anxiety, as reported by WHO. This works out to a US$1 trillion (RM4.7 trillion) loss in productivity each year. As an integral part of the Sustainable Development Goals (SDG 2030) agenda, there is an alarming concern on the negative economic impact from the widespread mental illness that affects the productivity and socio-economic conditions of Malaysia (Hassan et al., 2018). Therefore, actions to identify the risks in the workplace need to be done. Improvement actions need to be taken by employers to ensure the safety, health and well-being of the workplace is always maintained. 08.6: Work Stress According to the WHO, various situations at work can be labeled as "psychosocial hazards". It is because these things are related to the psychological and social conditions of the workplace rather than the physical conditions of the workplace. This can harm the psychosocial and physical health of the worker. This is also sometimes referred to as job stress. 14 08: Psychosocial Risk at the Workplace According to ILO, dangerous physical and emotional reactions are caused by an imbalance between demands and the individual's resources and ability to cope with those demands. Work-related stress is determined by work organization, work design and employee relations that occur when job demands are inappropriate or exceed the individual's capabilities. This situation leads to stress. Stress or pressure is "a non-specific response of the body to the request for change" that can occur in a positive or negative form. This condition also determines a person's health directly where health is generally recognized as a combination of biological, psychological factors (thoughts, emotions, and behavior behavior), and social (socio-economic, socio-environmental, and cultural). In 1994, the American Institute of Stress developed a simple model called the American Institute of Stress Traumatic Accident Model. This simple model explains how stress has a serious effect on a person, with a clear picture to employers that if employee stress is not handled wisely, it will have a serious effect involving the loss of ringgit money and may lead to a more serious security threat - human life. Figure 3: American Institute of Stress Traumatic Accident Model (Kamp, 1994) It is no exaggeration to say that the wealth of an organization depends on the health of its employees. Employees are a very valuable asset to every organization. Healthy employees will contribute to the productivity and wealth of the employer. Therefore, employers must always take care and ensure that the health conditions of their employees are in the best condition. 15 09: Gap Analysis National institutions in several countries have developed monitoring models, risk assessments, management tools, and other awareness-raising initiatives to help understand and prevent work-related stress. Nevertheless, Malaysia lacks a local model or reference as a guideline to assess and manage psychosocial risks at the workplace. In general, our national investment in mental health services remains low where <1% of the health budget allocated for it. The number of service providers is also low (1 psychiatrist, 1 clinical psychologist: 100,000 Malaysians). Other than low resources on mental health, the issue with stigma is also important. The stigma is due to low mental health literacy among Malaysian. For example, only 1:5 Malaysians who have mental health condition receive treatment and many others unable to identify the sign and symptom of poor mental health. Accordingly, in order to ensure that these guidelines meet current requirements, a gap analysis at the national and international levels has been carried out. In line with the core values it reflected in the ILO standards on occupational safety and health, they are expressed in three main principles: 1. Work must take place in a safe and healthy work environment. 2. Working conditions must be consistent with the well-being of workers and human dignity 3. Work should offer real possibilities for personal achievement, self-fulfilment and service to society. Referring to the issue of mental health of employees in the workplace, reports and issues of national workplace mental health are also quite limited. Psychosocial factors and workplace risks cannot be clearly stated in previous studies and reports. Due to this fact, DOSH has taken the initiative to develop PRisMA. This action is seen to be in line with the values ​applied under the ILO as above. 16 10: Standard Legislation The following is basic information about the legislation related to these guidelines. Any changes in terms of national legislation will directly affect these guidelines. Existing practices by employers and revisions are required to ensure these guidelines remain relevant over time. 10.1: Employment Psychosocial Legislation & Standards The core values protected in the ILO standards on occupational safety and health state these main principles, namely ILO Convention on Occupational Safety and Health, 1981 (No.155) and accompanying Recommendations (No.164) provide for the application, implementation and review of OSH and measures for its application in the workplace with the aim of protecting health and physical well-being and employee mentality. 10.1.1: ISO45003:2021 Occupational Health and Safety Management This is the latest guideline for managing psychosocial risks in an OSH management system based on ISO 45001. It enables organizations to prevent injuries and worker health related to their employees, in addition to helping employers promote well-being at work. This responsibility includes actions to protect the physical and psychological health of employees. Psychosocial hazards relate to how work is organised, social factors in the workplace and aspects of the work environment, equipment and hazardous tasks. It can occur in all organizations and sectors, and from all types of tasks, equipment and work arrangements. Psychosocial risks affect psychological health and safety, and health, safety and well-being in the workplace more broadly, and are often associated with economic costs to organizations and society. 10.1.2: Occupational Safety and Health Act (Amendment 2022) This act is amended and improved from the parent act; Occupational Safety and Health Act (1994). The changes to the A1648 act indeed have great implications for the safety and health aspects of workers in Malaysia. The effects and implications of these changes are explained in three parts as follows: 1. Coverage: Amendment of section 1 where this Act shall apply to all places of work throughout Malaysia including in the public services and statutory authorities except to the work specified in the First Schedule. 17 10: Standard Legislation 2. Responsibility: New sections 18a and 18b, where it shall be the duty of every principal to take, as far as is practicable, such measures as may be necessary to ensure safety and health. Every employer, self-employed person or principal shall carry out a risk assessment in relation to the safety and health risks exposed to any person who may be affected by their employment at the workplace and determining appropriate measures for risk control. 3. Implication: Amendment of section 19, in which any principal who contravenes the provisions of section 18 shall be guilty of an offence and liable to a fine not exceeding five hundred thousand. New section 28a shows the seriousness and protection by DOSH to any person who run occupational health services. No employer shall take any Action against any person carrying out occupational health services and this may include PRisMA program at the workplace. 18 11: Introduction to PRisMA The Psychosocial Risk Assessment and Management at the Workplace or PRisMA is a guideline for screening the psychosocial risks in the workplace and control measures to overcome those risks. PRisMA is not a diagnostic tool which unable to be used as a proof to support the causes of mental illness among workers at the workplace. PRisMA has developed an assessment instrument called Likelihood of Environment & Occupational Exposure Scale towards Psychosocial Risk at the Workplace (LEO26). LEO26 has been validated and the scores are compared with the gold standard assessment, the Job Content Questionnaire (JCQ). LEO26 evaluates three important components of psychosocial risk at the workplace namely; Job Control (JC), Work Demand (WD), and Job Support (JS). PRisMA is divided into two steps as follows: a. Step I – Risk Assessment b. Step II – Risk Management 11.1: Goal PRisMA was developed to meet the legislative goals in line with items 18a and 18b of the Occupational Safety and Health Act (Amendment 2022) - Act A1648. 11.2: Objectives PRisMA was developed to achieve the following objectives: 1. Provide a complete guidance to employers for screening of psychosocial risks in the workplace. 2. Provide guidance and recommended actions to be taken by employers in the control of psychosocial risks in the workplace. 3. Provide a standardized format for recordkeeping and monitoring of psychosocial health of workers in the workplace. 11.3: PRisMA Procedures The flow chart below shows how PRisMA Trained Person (PTP) should play a role in each phase. He must always maintain the confidentiality of the information received. 19 11: Introduction to PRisMA Figure 4: Flowchart of Psychosocial Risk Assessment and Management at the Workplace (PRisMA) 11.4: PRisMA Approach PRisMA highlighted two critical approaches employers could choose to deal with psychosocial risk at the workplace. Properly selecting this approach may lead to more value and productivity for the employer in the future. All reports are subject to be audited by DOSH on a yearly basis. 11.4.1: Proactive Approach A proactive approach in risk management refers to taking pre-emptive measures to identify, assess, and mitigate potential risks before they occur rather than reacting to them after they have already happened. It involves actively seeking out potential threats, analyzing their likelihood and impact, and implementing appropriate mitigation strategies to minimize or eliminate their negative consequences. By adopting a proactive approach to risk management, organizations can better anticipate and prepare for potential risks, reduce the likelihood and impact of adverse events, and enhance their overall resilience. This approach helps organizations stay ahead of the curve and enables them to seize opportunities while effectively managing potential threats. Proactive approach shows employer best practice towards prevention quality improvements. 20 11: Introduction to PRisMA 11.4.1: Reactive Approach A reactive approach in risk management refers to responding to risks after they have occurred or when they become apparent. Instead of actively seeking out and addressing potential risks proactively, a reactive approach focuses on managing risks as they arise and attempting to mitigate their negative consequences. While a reactive approach may be necessary in some situations, it is generally considered less effective and efficient than a proactive approach. The reactive approach may be driven by compliance requirements, regulatory mandates or as requested by the Director General (DG) of DOSH. Few indicators can be used to determine the requirement for the evaluation, such as; high absenteeism rate, high turnover rate and complaints from others. Any complaints reported or notification of psychosocial related cases, required for new assessment. 11.5: Step I: Risk Assessment Psychosocial risk assessment involves evaluating and identifying potential workplace risks to employees' psychological and social well-being. It assesses various factors impacting employees' mental health, job satisfaction, and psychological well-being. By conducting a psychosocial risk assessment, organizations can identify areas of concern and take appropriate measures to prevent or mitigate these risks, thereby promoting a healthier work environment. Either the employer chooses the proactive or reactive approach; the PRisMA risk assessment starts with mass data collection among workers using LEO26 as the tool. The LEO26 score will guide PTP in selecting the appropriate actions under the risk management activities. If the LEO26 score falls under the high category, further analysis will be conducted by PTP. Risk analysis will identify the priority of management action according to ranking (high and low priority). The risk analysis will provide information related to LEO priority according to the total workplace score. These total scores are derived from employee responses. 11.6: Step II: Risk Management Psychosocial risk management involves implementing strategies and measures to prevent, mitigate, or manage the psychosocial risks that can impact employees' psychological and social well-being. It aims to create a supportive work environment that promotes mental health, job satisfaction, and overall well-being. Details of risk management will be further discussed in the next section. 21 11: Introduction to PRisMA 11.7: Screening Tools Several tools have been developed to achieve the objectives of PRisMA. The following is a summary of the tools used in these guidelines: i. Likelihood of Environment & Occupational Exposure Scale towards Psychosocial Risk at the Workplace (LEO26) LEO26 is a screening tool guided by the International Labor Organization (ILO) and in line with the development of ISO 45003: 2021 Occupational Health and Safety Management – Psychological Health and Safety at Work – Guidelines for Managing Psychosocial Risks. LEO26 is used to assess the likelihood that the workplace environment and work activities of an employee contribute to their psychosocial health status. LEO26 will help employees and employers take appropriate action. LEO26 has gone through a process of validation. It uses the cut-off value principle where the setting of the risk rate (high or low) is determined through the value obtained. This value is likely to change from one workplace to another. ii. Employer Practice Checklist 23 (EPC23) The checklist consists of 23 points that will be used as a guide to employers to take necessary actions towards their LEO26 score. The total score of LEO26 categories will be individually matched with the 23 points of this checklist. Employers will refer to this checklist as part of their psychosocial risk management at the workplace. However, employers are only required to fill in the checklist once their organizational score falls under the category of high risk. This information will be used by PTP to match LEO26 and EPC23 for risk prioritization. 11.8: Employer's Roles and Responsibilities Employers are responsible for the function of the OSH management system in determining roles and responsibilities for managing psychosocial risks in the workplace. Effective psychosocial risk management requires active participation from the employer. The employer shall conduct the risk assessment according to the stipulated act. Employers are also responsible to appoint PTP to conduct the PRisMA. 11.9: PRisMA Trained Person PRisMA Trained Person (PTP) must be individuals who have gone through training and passed tests and coursework assessments. Individuals with a medical background have an advantage, however they are also subject to attending courses and passing relevant tests. The PTP appointed by the employer are responsible for carrying out the processes as stated in these guidelines. PTP’s must maintain the confidentiality of all information and perform duties with integrity. 22 11: Introduction to PRisMA 11.10: Employees Roles and Responsibilities All employees must cooperate with the employer in all activities organized under PRisMA. Employees are also responsible to report any psychosocial issues in the workplace to the employer. 11.11: Scope These guidelines are to be adopted by employers and employees as a guide to the assessment and management of psychosocial risks in the workplace. The scope of these guidelines includes: a. Workplace Psychosocial Risk Assessment b. Psychosocial Risk Management In order to achieve the purpose of risk assessment, these guidelines will use LEO26 score as a guide to the risk. The EPC23 will be used as a guide for the next step. While to help employers manage identified risks, a schedule of priority actions is provided in these guidelines along with recommended action times for actions to be taken. 11.12: Application All employees are required to fill out this screening tool with the aim of assessing psychosocial risks in their respective workplaces. Employers and PTP’s are responsible for ensuring that this personal data is kept secure and confidential. All assessments will begin with collection of individual employee data. This data is then consolidated either by unit, division, section, area and other relevant clusters or groups. This risk assessment needs to be reported separately from one section to another. Employers can assess the workplace as a whole. Reporting and action must be done accordingly. For employers who only have one division, one assessment and report is sufficient. Employers and PTP need to discuss and carry out assessment actions based on reasonable needs. The employer is responsible for ensuring that the assessment and reporting is done at least every two years. 11.13: Reporting PRisMA findings must be reported according to the format provided. PTP has to report their findings based on the format provided and presented as an aggregate information without revealing personal information. PTP needs to refer to the LEO26 final score and matching with the EPC23. All this information is confidential and should be kept in a safe place. The records must be kept according to the existing practice of the employer or for seven (7) years or whichever is longer. 23 11: Introduction to PRisMA 11.14: Re-assessment LEO26 must be conducted every 12 months for high risk organizational score and 2 years for low risk organizational score. However, assessment may take place at any time if the conditions of reactive approach are fulfilled. 11.15: Limitation PRisMA is not a diagnostic tool. The screening data obtained will provide guidance to employers and employees regarding psychosocial risks found in the workplace. Factors other than employment need to be assessed separately. All risk management included in this guideline are used as suggestions only, and it is not mandatory to be applied. 24 12: Risk Assessment Risk assessment is an essential step in PRisMA. No risk management shall be conducted before clearly understanding employees' psychosocial risk status. In order to conclude the final organizational risk score, two category of analysis were mandatory as follows: a. Category 1 – Individual Risk Score b. Category 2 – Cumulative Organizational Risk Score a. Category 1 – Individual Risk Score Risk assessment will start with the distribution of LEO26 to all employees. In order to ensure data confidentiality, only the following basic employee data will be collected: a. Name of current department/unit b. Years of working experience in current department/unit i. 1 – 5 years ii. 6 – 10 years iii. 11 – 15 years v. 16 – 20 years v. More than 20 years. c. Workers category (according to the job structures in the organization), e.g.: management, executive, operation. Once this form is completed and returned to PTP, these data will be analyzed. PTP needs to do the calculation based on the formula below. Individual risk will be identified based on the score obtained. As for the group score, the average group score obtained will be used to compare the cut-off value given. The risk values will be determined based on this comparison. LEO26 Components Risk Indicator (Individual) Job Control (JC) Q1+Q2+Q3+Q7+Q8+Q9+Q10+Q11+Q12+Q14+Q16 Low ≥14.5 High Work Demand (WD) Q4+Q5+Q6+Q25+Q26 Low ≥6.5 High Job Support (JS) Q13+Q15+Q17+Q18+Q19+Q20+Q21+Q22+Q23+Q24 High ≤12.5 Low Table 1: LEO26 Individual Risk Score Table PTP is required to select the correct result according to the LEO26 risk score table as above. 25 12: Risk Assessment b. Category 2 – Cumulative Organizational Risk Score Category 2 of risk analysis will require the PTP to calculate the total percentage of individual components of LEO26: a) Job Control, b) Work demand, and c) Job Support. To identify the organizational risk score, the PTPs must pay attention to the percentages of the high-risk score for each LEO26’s components. Any components that exceed the high-risk percentage will be required to conduct risk management at the workplace. LEO26 Components LEO26 Cumulative Score (Cut-Off %) Risk Indicator (Cumulative)* Job Control (JC) 50% and above High Work Demand (WD) 25% and above High Job Support (JS) 25% and above High Table 2: LEO26 Cumulative Risk Score Table 12.1: Risk Assessment Process The PTP is recommended to refer to the step-by-step guide from a to c: a. Step 1 - The PTP distributes the LEO26 form. b. Step 2 - The PTP collects the LEO26 form. c. Step 3 i. Step 3.1: The PTP conducts a risk analysis. PTP may develop their own excel calculator to identify the final risk score. ii. Step 3.2: Individual Score - PTP needs to refer to the LEO26 Individual Risk Score Table (Refer Table 1: LEO26 Individual Risk Score Table). iii. Step 3.3: Group Score - Group analysis can only be finalized based on the collection of individual score. PTP needs to refer to the LEO26 Cumulative Risk Score Table (Refer Table 2: LEO26 Cumulative Risk Score Table). 26 13: Risk Management Risk management will be conducted based on the high score of total organizational risk score from LEO26. Analysis of LEO26 and matching with EPC23 will provide appropriate suggestions for risk control. These guidelines provide relevant recommendations. The PTP’s also need to refer to the employer's policies and procedures in the management of psychosocial risk. The duration of risk control actions is divided into short term (1-6 months) and long term (12 months). Employers are advised to constantly monitor the psychosocial risk of their employees. All employee-related information must be carefully guarded and kept confidential. Immediate assessment can be done for certain cases and special needs. Step II of the figure will suggest how employers should manage the psychological risk findings according to priority. PTP should refer to the table below for selection and action toward risk management. These guidelines specifically guide employers to prioritize psychosocial risk management actions based on the priority. 13.1: Risk Management Process The PTP is recommended to refer to the step-by-step guide from d to g. d. Step 4 i. Step 4.1: Based on the results of Step 3, the PTP needs to identify the need for the employer to fill in the EPC23 form. ii. Step 4.2: If any of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP must ask the employer to fill in the EPC23 form. Proceed with step 5. iii. Step 4.3: If none of the LEO26 components (JC, WD, JS) has a high-risk score, the PTP shall proceed up to step 7 according to the PRisMA work process. e. Step 5 - For any of the LEO26 components (JC, WD, JS) scores with a highrisk value, PTP must match LEO26 components and EPC23 scores for risk prioritization. The priority matching process is based on the following steps: i. Step 5.1: Highlight all LEO26 cumulative risk scores from Step 3. ii. Step 5.2: Review the LEO26 components score. This guideline uses a colorcoding system to assist the PTP in this exercise. Kindly refer to the same color for each steps mentioned. Refer to Table 5 for Risk Management Based on LEO26 Components and EPC23. 27 13: Risk Management iii. Step 5.3: Review the EPC23 score. Match the needs accordingly using Table 3 and Table 4. iv. Step 5.4: Refer to the color that represents the theme and action. Identify the correct interventions for each psychosocial risk identified. LEO26 Components Item Risk Management (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Job Support (JS) Role in the Organization 6, 8, 19 Job Support (JS) Relationship Between Friends 7, 13, 21 Job Support (JS) Organizational Culture 2, 10, 16, 22, 23 Work Demand (WD) Balance Work and Daily Life 3, 15 Work Demand (WD) Working Hours 4, 11, 18 Table 3: Risk Management Based on LEO26 Components and EPC23 Table If the answer is No, kindly refer to the related action Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) 1 Ensure the psychosocial risk of my employees is managed accordingly. Social Support 2 Ensure transparency and fairness in complaints handling procedures. Transparency and Fairness 3 Ensure tasks are clearly defined. Job Matching 4 Ensure work hours are predictable and reasonable. 28 Yes/No (√ / X) Workload 13: Risk Management If the answer is No, kindly refer to the related action Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) 5 Provide appropriate lighting, equipment, air quality, and noise levels in the workplace. Working Environment 6 Assign tasks according to experience and competence. Job Matching 7 Strengthen motivation by emphasizing the positive and useful aspects of work. Social Support 8 Establish clear roles, and avoid role conflicts and ambiguity. Job Matching 9 Provide job security as far as possible. Working Environment 10 Provide an infrastructure where supervisors are responsible for other employees and have an appropriate level of communication. Control 11 Ensure the level of human resources & staff is sufficient. Control 12 Taking ergonomic aspects into account to limit stress on workers. Working Environment 13 Ensure there is a good relationship between supervisors and employees. Social Support 14 Ensure proper use of skills. Job Matching 15 Encourage employees to discuss any conflicting demands between work and home. Transparency and Fairness 16 Provide information on psychosocial risk and work-related stress and how to prevent them. Training and Education 17 Match the job with the employee's physical and psychological skills and abilities. Job Matching 29 Yes/No (√ / X) 13: Risk Management Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) Yes/No (√ / X) If the answer is No, kindly refer to the related action 18 Periodically assess the time requirements of a job and set a reasonable deadline/pace. 19 Allow employees to express how their work is carried out Transparency and Fairness 20 Provide adequate training to ensure skills and jobs are appropriate for employees. Training and Education 21 Create positive relationships between employees. Social Support 22 Keep the workplace free from physical and psychological violence. Working Environment 23 Provide psychosocial support for employees with mental health conditions. Social Support Workload Table 4: Employer Practice Checklist (EPC23) Theme Action Control 1. To ensure adequate resource levels. 2. To review current job process; rotate and rearrange if possible to improve productivity. 3. To discuss with workers the opportunity to control the occupational activities and sub-activities, according to workers’ performance. 4. To provide opportunities for workers to manage their work, such as selection of location (home or office) and work pace. 5. To allow employees a say in how their jobs are conducted. 6. To discuss with workers how to involve in decision-making (where applicable). Workload 1. To continually assess time requirements and set reasonable deadlines. 2. To ensure that working hours are predictable and reasonable 30 13: Risk Management Theme Action Social Support 1. To create positive relationships between employees. 2. To maintain a workplace free from physical and psychological violence. 3. To ensure there is a good relationship between supervisors and employees 4. To provide an infrastructure where supervisors are responsible for other employees and have an appropriate level of communication. 5. To encourage employees to discuss any conflicting demands between work and home. 6. To strengthen motivation by emphasizing positive and useful aspects of career. 7. To conduct mental health screening programs, for example, DASS21 8. To provide support on workers’ welfare to ease daily work components such as; flexible working hours, child care center, marriage and family counseling, money management, and others. 9. To encourage participation in social activities such as family day, sports day, festive season celebration etc. Job Matching 1. To ensure jobs that match the employee's physical and psychological skills and abilities. 2. To assign tasks according to experience and competence. 3. To ensure proper use of skills. 4. To ensure workers’ roles and responsibilities are clearly defined Training and Education 1. To provide adequate training to ensure that skills and jobs are suitable for employees. 2. To provide information on psychosocial risks and work-related stress and how to prevent them. 3. To organize mental health awareness programs such as emotional support, stress and anger management, and overcoming burnout at the workplace. 4. To introduce and provide proper job management at the workplace. 5. To provide specific training such as psychosocial program by occupational therapist, latihan minda sihat di tempat kerja (Ministry of Health) and DASS21 screening program. 6. To provide training that relates to workers’ real duty. 31 13: Risk Management Theme Action Transparency and Fairness 1. To ensure tasks are clearly defined. 2. To provide clear roles, avoid role conflicts and ambiguity. 3. To provide job security as far as possible. 4. To provide adequate wages for work performed. 5. To ensure transparency and fairness in complaint-handling procedures. Working Environment 1. To provide appropriate lighting, equipment, air quality, and noise levels. 2. To avoid exposure to harmful agents. 3. To take into account ergonomic aspects to limit worker stress. 4. To address incivility in the workplace – internal and external. 5. To train workers to adapt to multiple working environments; physical, psychological, emotional, and social. Table 5: Collective Measures Managing Psychosocial Risk at Work Table v. Step 5.5: Under certain circumstances, mismatches between the employee's cumulative score of LEO26 components and EPC23 may happen. PTP must prioritize psychosocial risk management based on employees' cumulative score of LEO26 components first, followed by EPC23. This situation needs to be explained to the employer. f. Step 6 - The PTP presents the assessment results and psychosocial risk management measures that need to be taken to the employer. g. Step 7 - The appointed PTP conducts a re-evaluation based on the PRisMA work process. i. Step 7.1: If any of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP or appointed consultant must re-evaluate after 12 months. ii. Step 7.2: If none of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP shall re-evaluate after two years or when needed according to reactive criteria. All records must be kept for audit and process improvement purposes. 32 14: Scenarios of Workplace Psychosocial Issues These guidelines will provide some form of decision. The results can be used as a reference for any further action. Below are examples of cases and actions that must be taken by the employer. 14.1: Case 1 – Workplace Score (Proactive Approach) KGB Company is a multinational printing company headquartered in Kuala Lumpur. The company also has a branch in Sandakan, Sabah. The company has a total of 1,000 employees. Each branch has the same number of employees under three units: the booking unit (100 employees), the digital unit (200 employees), and the distribution unit, with 200 employees. Based on responsibility, employers have taken proactive steps to participate in the PRisMA program. The employer has screened all employees at both of their premises. The PTP is recommended to refer to the step-by-step guide from a to g. a) Step 1 - The PTP distributes the LEO26 form. b) Step 2 - PTP collects the LEO26 form. c) Step 3 - PTP conducts a risk analysis. PTP may develop their own excel calculator to identify the final risk score. Step 3.1 - Individual Score. PTP needs to refer to the LEO26 risk table as follow (Individual Score). Items Risk Indicator (Individual) Job Control (JC) Q1+Q2+Q3+Q7+Q8+Q9+Q10+Q11+ Q12+Q14+Q16 Low ≥14.5 High Work Demand (WD) Q4+Q5+Q6+Q25+Q26 Low ≥6.5 High Job Support (JS) Q13+Q15+Q17+Q18+Q19+Q20+Q21 +Q22+Q23+Q24 High ≤12.5 Low Step 3.2 - Group Score. Group analysis can only be finalized based on the collection of individual score. PTP needs to refer to the LEO26 risk table as follow (group score). 33 14: Scenarios of Workplace Psychosocial Issues LEO26 Components LEO26 High-Risk Cut-Off (%) Risk Indicator (Cumulative) Job Control (JC) 50% and above High Work Demand (WD) 25% and above High Job Support (JS) 25% and above High The following are the results of the assessment. Kuala Lumpur Headquarters Unit/Number of Employees Booking Unit 100 employees Digital Unit 200 employees Distribution Unit 200 employees LEO26 Components Score (%), (Unit Employees) Risk Status JC 70% (70 employees) High WD 20% (20 employees) Low JS 10% (10 employees) Low JC 40% (80 employees) Low WD 25% (50 employees) High JS 10% (20 employees) Low JC 30% (60 employees) Low WD 20% (40 employees) Low JS 25% (50 employees) High Sandakan, Sabah Unit/Number of Employees Booking Unit 100 employees LEO26 Components Score (%), (Unit Employees) Risk Status JC 40% (40 employees) Low WD 20% (20 employees) Low JS 10% (10 employees) Low 34 14: Scenarios of Workplace Psychosocial Issues Unit/Number of Employees Digital Unit 200 employees Distribution Unit 200 employees LEO26 Components Score (%), (Unit Employees) Risk Status JC 40% (80 employees) Low WD 20% (40 employees) Low JS 10% (20 employees) Low JC 20% (40 employees) Low WD 20% (40 employees) Low JS 20% (40 employees) Low d) Step 4 - Based on the results of Step 3, the PTP needs to identify the need for the employer to fill in the EPC23 form. Step 4.1 - If any of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP must ask the employer to fill in the EPC23 form. Proceed with Step 5. Step 4.2 - If none of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP shall proceed to Step 7 according to the PRisMA work process. Since the Kuala Lumpur Head Office score has a high-risk score on the booking unit (JC), digital unit (WD), and distribution unit (JS), the PTP needs to ask the employer in Kuala Lumpur (according to the unit involved) to fill in the EPC23 form. All units in the Sandakan branch do not require an EPC23 assessment, and a reassessment can be carried out after two years or based on requirements such as the criteria under the reactive approach category. e) Step 5 - For any of the LEO26 components (JC, WD, JS) scores with a highrisk value, PTP must match LEO26 and EPC23 scores for risk prioritization. The priority matching process is based on the example below: Step 5.1 - Highlight all LEO26 Cumulative Risk Scores from Step 3. 35 14: Scenarios of Workplace Psychosocial Issues Kuala Lumpur Headquarters Unit/Number of Employees LEO26 Components Score (%), (Unit Employees) LEO26 HighRisk Cut-Off (%) Risk Status Booking Unit 100 employees JC 70% (70 employees) 50% and above High Digital Unit 200 employees WD 25% (50 employees) 25% and above High Distribution Unit 200 employees JS 25% (50 employees) 25% and above High Step 5.2 - Review the LEO26 Components Score. This guideline uses a colorcoding system to assist the PTP in this exercise. Kindly refer to the same color for each step mentioned. Since we have three units to analyze, Steps 5.2.1 to 5.2.3 show the example of the EPC23 score from each separate unit. Following is the table of psychosocial risk management at the workplace based on EPC23. LEO26 Components Item Risk Management (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Job Support (JS) Role in the Organization 6, 8, 19 Job Support (JS) Relationship Between Friends 7, 13, 21 Job Support (JS) Organizational Culture 2, 10, 16, 22, 23 Work Demand (WD) Balance Work and Daily Life 3, 15 Work Demand (WD) Working Hours 4, 11, 18 Step 5.2.1: EPC23 Booking Unit - Identify EPC23 scores according to the individual unit (high-risk only). Pay attention to psychosocial risk management for JC items only. 36 14: Scenarios of Workplace Psychosocial Issues LEO26 Components Item Risk Management (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Step 5.2.2: EPC23 Digital Unit - Identify EPC23 scores according to the individual unit (high-risk only). Pay attention to psychosocial risk management for WD items only. LEO26 Components Item Risk Management (1 – 23) Work Demand (WD) Balance Work and Daily Life 3, 15 Work Demand (WD) Working Hours 4, 11, 18 Step 5.2.3: EPC23 Distribution Unit - Identify EPC23 scores according to the individual unit (high-risk only). Pay attention to psychosocial risk management for JS items only. LEO26 Components Item Risk Management (1 – 23) Job Support (JS) Role in the Organization 6, 8, 19 Job Support (JS) Relationship Between Friends 7, 13, 21 Job Support (JS) Organizational Culture 2, 10, 16, 22, 23 Step 5.3 - Review the EPC23 Score. Match the needs accordingly using Table 3, 4 and 5. Since we have three units to propose for interventions, Steps 5.3.1 to 5.3.3 show the example of appropriate interventions for each No answer from the EPC23. 37 14: Scenarios of Workplace Psychosocial Issues 5.3.1 Job Control - Matching between JC and EPC23 (No score only). Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) Yes/No (√ / X) If the answer is No, kindly refer to the related action 1 Ensure the psychosocial risk of my employees is managed accordingly. X Social Support 9 Provide job security as far as possible. X Working Environment 20 Provide adequate training to ensure skills and jobs are appropriate for employees. X Training and Education 5.3.2 Work Demand - Matching between WD and EPC23 (No score only). Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) Yes/No (√ / X) If the answer is No, kindly refer to the related action 3 Ensure tasks are clearly defined. X Job Matching 4 Ensure work hours are predictable and reasonable. X Workload 11 Ensure the level of human resources & staff is sufficient. X Control 5.3.3 Job Support - Matching between JS and ECP23 (No score only). Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) Yes/No (√ / X) If the answer is No, kindly refer to the related action 6 Assign tasks according to experience and competence. Job Matching 10 Provide an infrastructure where supervisors are responsible for other employees and have an appropriate level of communication. Control 13 Ensure there is a good relationship between supervisors and employees. Social Support 38 14: Scenarios of Workplace Psychosocial Issues Step 5.4 - Refer to the color that represents the theme and action. Since we have three different units with different interventions, Steps 5.3.1 to 5.3.3 show examples of the selected interventions from each unit. Review the EPC23 score. Match the needs accordingly using Table 3 and 4. Collective Measures Managing Psychosocial Risk at Work. Theme Action Control 1. To ensure adequate resource levels. 2. To review current job process; rotate and rearrange if possible to improve productivity. 3. To discuss with workers the opportunity to control the occupational activities and sub-activities, according to workers’ performance. 4. To provide opportunities for workers to manage their work, such as selection of location (home or office) and work pace. 5. To allow employees a say in how their jobs are conducted. 6. To discuss with workers how to involve in decision-making (where applicable). Workload 1. To continually assess time requirements and set reasonable deadlines. 2. To ensure that working hours are predictable and reasonable Social Support 1. To create positive relationships between employees. 2. To maintain a workplace free from physical and psychological violence. 3. To ensure there is a good relationship between supervisors and employees 4. To provide an infrastructure where supervisors are responsible for other employees and have an appropriate level of communication. 5. To encourage employees to discuss any conflicting demands between work and home. 6. To strengthen motivation by emphasizing positive and useful aspects of career. 7. To conduct mental health screening programs, for example, DASS21 8. To provide support on workers’ welfare to ease daily work components such as; flexible working hours, child care center, marriage and family counseling, money management, and others. 9. To encourage participation in social activities such as family day, sports day, festive season celebration etc. 39 14: Scenarios of Workplace Psychosocial Issues Theme Action Job Matching 1. To ensure jobs that match the employee's physical and psychological skills and abilities. 2. To assign tasks according to experience and competence. 3. To ensure proper use of skills. 4. To ensure workers’ roles and responsibilities are clearly defined Training and Education 1. To provide adequate training to ensure that skills and jobs are suitable for employees. 2. To provide information on psychosocial risks and work-related stress and how to prevent them. 3. To organize mental health awareness programs such as emotional support, stress and anger management, and overcoming burnout at the workplace. 4. To introduce and provide proper job management at the workplace. 5. To provide specific training such as psychosocial program by occupational therapist, latihan minda sihat di tempat kerja (Ministry of Health) and DASS21 screening program. 6. To provide training that relates to workers’ real duty. Transparency and Fairness 1. To ensure tasks are clearly defined. 2. To provide clear roles, avoid role conflicts and ambiguity. 3. To provide job security as far as possible. 4. To provide adequate wages for work performed. 5. To ensure transparency and fairness in complaint-handling procedures. Working Environment 1. To provide appropriate lighting, equipment, air quality, and noise levels. 2. To avoid exposure to harmful agents. 3. To take into account ergonomic aspects to limit worker stress. 4. To address incivility in the workplace – internal and external. 5. To train workers to adapt to multiple working environments; physical, psychological, emotional, and social. Step 5.4.1 Booking Unit: JC interventions - Matching and prioritizing psychosocial risk management according to LEO26 and EPC23. 40 14: Scenarios of Workplace Psychosocial Issues Theme Action Social Support 1. To create positive relationships between employees. 2. To maintain a workplace free from physical and psychological violence. 3. To ensure there is a good relationship between supervisors and employees 4. To provide an infrastructure where supervisors are responsible for other employees and have an appropriate level of communication. 5. To encourage employees to discuss any conflicting demands between work and home. 6. To strengthen motivation by emphasizing positive and useful aspects of career. 7. To conduct mental health screening programs, for example, DASS21 8. To provide support on workers’ welfare to ease daily work components such as; flexible working hours, child care center, marriage and family counseling, money management, and others. 9. To encourage participation in social activities such as family day, sports day, festive season celebration etc. Training and Education 1. To provide adequate training to ensure that skills and jobs are suitable for employees. 2. To provide information on psychosocial risks and work-related stress and how to prevent them. 3. To organize mental health awareness programs such as emotional support, stress and anger management, and overcoming burnout at the workplace. 4. To introduce and provide proper job management at the workplace. 5. To provide specific training such as psychosocial program by occupational therapist, latihan minda sihat di tempat kerja (Ministry of Health) and DASS21 screening program. 6. To provide training that relates to workers’ real duty. Working Environment 1. To provide appropriate lighting, equipment, air quality, and noise levels. 2. To avoid exposure to harmful agents. 3. To take into account ergonomic aspects to limit worker stress. 4. To address incivility in the workplace – internal and external. 5. To train workers to adapt to multiple working environments; physical, psychological, emotional, and social. 41 14: Scenarios of Workplace Psychosocial Issues Step 5.4.2 Digital Unit: WD Interventions - Matching and prioritizing psychosocial risk management according to LEO26 and EPC23. Theme Action Control 1. To ensure adequate resource levels. 2. To review current job process; rotate and rearrange if possible to improve productivity. 3. To discuss with workers the opportunity to control the occupational activities and sub-activities, according to workers’ performance. 4. To provide opportunities for workers to manage their work, such as selection of location (home or office) and work pace. 5. To allow employees a say in how their jobs are conducted. 6. To discuss with workers how to involve in decision-making (where applicable). Workload 1. To continually assess time requirements and set reasonable deadlines. 2. To ensure that working hours are predictable and reasonable Job Matching 1. To ensure jobs that match the employee's physical and psychological skills and abilities. 2. To assign tasks according to experience and competence. 3. To ensure proper use of skills. 4. To ensure workers’ roles and responsibilities are clearly defined Step 5.4.3 Distribution unit: JS Interventions - Matching and prioritizing psychosocial risk management according to LEO26 and EPC23. Theme Action Control 1. To ensure adequate resource levels. 2. To review current job process; rotate and rearrange if possible to improve productivity. 3. To discuss with workers the opportunity to control the occupational activities and sub-activities, according to workers’ performance. 4. To provide opportunities for workers to manage their work, such as selection of location (home or office) and work pace. 5. To allow employees a say in how their jobs are conducted. 6. To discuss with workers how to involve in decision-making (where applicable). 42 14: Scenarios of Workplace Psychosocial Issues Theme Action Social Support 1. To create positive relationships between employees. 2. To maintain a workplace free from physical and psychological violence. 3. To ensure there is a good relationship between supervisors and employees 4. To provide an infrastructure where supervisors are responsible for other employees and have an appropriate level of communication. 5. To encourage employees to discuss any conflicting demands between work and home. 6. To strengthen motivation by emphasizing positive and useful aspects of career. 7. To conduct mental health screening programs, for example, DASS21 8. To provide support on workers’ welfare to ease daily work components such as; flexible working hours, child care center, marriage and family counseling, money management, and others. 9. To encourage participation in social activities such as family day, sports day, festive season celebration etc. Job Matching 1. To ensure jobs that match the employee's physical and psychological skills and abilities. 2. To assign tasks according to experience and competence. 3. To ensure proper use of skills. 4. To ensure workers’ roles and responsibilities are clearly defined Step 5.5 - Under certain circumstances, mismatches between the employee's cumulative score of LEO26 components and EPC23 may happen. PTP must prioritize psychosocial risk management based on employees' cumulative score of LEO26 components first, followed by EPC23. This situation needs to be explained to the employer. f) Step 6 - The PTP presents the assessment results and psychosocial risk management measures that need to be taken to the employer. g) Step 7 - The appointed PTP conducts a re-evaluation based on the PRisMA work process. Step 7.1 - If any of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP or appointed consultant must re-evaluate after 12 months. 43 14: Scenarios of Workplace Psychosocial Issues Step 7.2 - If none of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP or appointed consultant shall re-evaluate after two years or when needed according to reactive criteria. Sandakan, Sabah - Re-evaluate after two years or when needed according to reactive criteria. All records must be kept for audit and process improvement purposes. 14.2: Case 2 – High Risk Score (Reactive Approach) Sri Chempaka Bulan is a small government agency that consists of 500 workers. Those workers work under five different departments as follows: Failing Finance Audit – the source of the complaints Housekeeping Student affairs A few weeks ago, the management received a complaint from the audit department saying that a few workers have shown poor work productivity, including high absenteeism. This is not the first time management has noticed such a complaint, yet action has yet to be taken. Unfortunately, this time, the news has become viral and drawn public attention, including at the ministerial level. The employer has no choice but to proceed with the PRisMA program. The employer may proceed with a reactive approach. The employer has an option either to proceed with the audit department or all five departments. The PTP is recommended to refer to the step-by-step guide from a to g. All records must be kept for audit and process improvement purposes. 14.3: Case 3 – Existing Risk Management Program My employer already has an existing psychosocial health management program at work. What should I do? Proposal: Employers with established programs that are on par with PRisMA, can continue the existing practice OR may choose to adopt these guidelines. 44 15: Appendix - List of Forms & Information The following is a list of forms used in this manual: 1. Appendix 1: PRisMA Form 1 – Likelihood of Environment & Occupational Exposure Scale Towards Psychosocial Risk at the Workplace (LEO26) 2. Appendix 2: PRisMA Form 2 – Employer Practice Checklist 23 (EPC23) 3. Appendix 3: PRisMA Form 3 – Workplace Psychosocial Risk Reporting 4. Appendix 4: MSIC 2008 Industry Reference List 5. Appendix 5: First Schedule - Act A1648 6. Appendix 6: List of Contributors 45 15: APPENDIX 1: PRisMA Form 1 – Likelihood of Environment & Occupational Exposure Scale Towards Psychosocial Risk at the Workplace (LEO26) Name of Current Department/Unit: ________________________________________________ Years of working experience in current department/unit: Numbers of Year Please Tick (/) 1 – 5 years 6 – 10 years 11 – 15 years 16 – 20 years more than 20 years. Workers Category (according to the job structures in the organization e.g. Management, Executive, Operation: _______________________________________________ Please read each statement and circle 1, 2, 3, 4, or 5, indicating how much the statement applied to your work over the past six (6) months. There are no right or wrong answers. Do not spend too much time on any statement. The rating scale is as follows: 1 Never 2 Seldom 3 Sometimes 4 Often 5 Always 1.My work is boring. 1 2 3 4 5 2. My work lacks variety. 1 2 3 4 5 3. My work is meaningless. 1 2 3 4 5 4. I am required to work long hours. 1 2 3 4 5 5. My working hours are not flexible. 1 2 3 4 5 6. My working hours are unpredictable. 1 2 3 4 5 46 15: APPENDIX 1: PRisMA Form 1 – Likelihood of Environment & Occupational Exposure Scale Towards Psychosocial Risk at the Workplace (LEO26) 7. My work area is poorly maintained. 1 2 3 4 5 8. My work equipment is poorly maintained. 1 2 3 4 5 9. My work equipment is inadequate. 1 2 3 4 5 10. My work area is not safe. 1 2 3 4 5 11. I am not comfortable working in my work area. 1 2 3 4 5 12. My career development opportunity is unfair. 1 2 3 4 5 13. I am given the opportunity to achieve my full potential. 1 2 3 4 5 14. I do not have the chance to develop my skills. 1 2 3 4 5 15. My role in the organization is clear. 1 2 3 4 5 16. I receive conflicting instructions to perform my work. 1 2 3 4 5 17. I have a good relationship with my co-workers. 1 2 3 4 5 18. I have a good relationship with my superior. 1 2 3 4 5 19. I receive good support from my co–workers. 1 2 3 4 5 20. I receive good support from my superior. 1 2 3 4 5 21. I have the opportunity to receive feedback from my superior. 1 2 3 4 5 22. I am able to voice out concerns to my superior. 1 2 3 4 5 23. My superior is open to suggestions from workers. 1 2 3 4 5 24. My top management cares about workers’ wellbeing. 1 2 3 4 5 25. I have to sacrifice my personal time due to my work commitments. 1 2 3 4 5 26. I miss social activities due to my work commitments. 1 2 3 4 5 47 15: APPENDIX 1: PRisMA Form 1 – Likelihood of Environment & Occupational Exposure Scale Towards Psychosocial Risk at the Workplace (LEO26) Action indicator, circle where is appropriate: LEO26 Components Risk Indicator (Individual) Job Control (JC) Q1+Q2+Q3+Q7+Q8+Q9+Q10+Q11+ Q12+Q14+Q16 Low ≥14.5 High Work Demand (WD) Q4+Q5+Q6+Q25+Q26 Low ≥6.5 High Job Support (JS) Q13+Q15+Q17+Q18+Q19+Q20+Q21 +Q22+Q23+Q24 High ≤12.5 Low Thank you for your cooperation. 48 15: APPENDIX 2: PRisMA Form 2 – Employer Practice Checklist 23 (EPC23) As an employer, I….... If the answer is No, kindly refer to the related action Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) 1 Ensure the psychosocial risk of my employees is managed accordingly. Social Support 2 Ensure transparency and fairness in complaints handling procedures. Transparency and Fairness 3 Ensure tasks are clearly defined. Job Matching 4 Ensure work hours are predictable and reasonable. Workload 5 Provide appropriate lighting, equipment, air quality, and noise levels in the workplace. Working Environment 6 Assign tasks according to experience and competence. Job Matching 7 Strengthen motivation by emphasizing the positive and useful aspects of work. Social Support 8 Establish clear roles, and avoid role conflicts and ambiguity. Job Matching 9 Provide job security as far as possible. Working Environment 10 Provide an infrastructure where supervisors are responsible for other employees and have an appropriate level of communication. Control 11 Ensure the level of human resources & staff is sufficient. Control 12 Taking ergonomic aspects into account to limit stress on workers. Working Environment 13 Ensure there is a good relationship between supervisors and employees. Social Support 49 Yes/No (√ / X) 15: APPENDIX 2: PRisMA Form 2 – Employer Practice Checklist 23 (EPC23) As an employer, I….... Risk Management (1 – 23) Employer Practice Checklist 23 (EPC23) Yes/No (√ / X) If the answer is No, kindly refer to the related action 14 Ensure proper use of skills. Job Matching 15 Encourage employees to discuss any conflicting demands between work and home. Transparency and Fairness 16 Provide information on psychosocial risk and work-related stress and how to prevent them. Training and Education 17 Match the job with the employee's physical and psychological skills and abilities. Job Matching 18 Periodically assess the time requirements of a job and set a reasonable deadline/pace. 19 Allow employees to express how their work is carried out Transparency and Fairness 20 Provide adequate training to ensure skills and jobs are appropriate for employees. Training and Education 21 Create positive relationships between employees. Social Support 22 Keep the workplace free from physical and psychological violence. Working Environment 23 Provide psychosocial support for employees with mental health conditions. Social Support 50 Workload 15: APPENDIX 3: PRisMA Form 3 – Workplace Psychosocial Risk Reporting WORKPLACE PSYCHOSOCIAL RISK REPORT Cumulative Score Obtained (%) LEO26 Components LEO26 High-Risk Cut-Off (%) (Cumulative) Job Control (JC) 50% and above Low High Work Demand (WD) 25% and above Low High Job Support (JS) 25% and above Low High Risk Indicator (Cumulative)* * Circle where is appropriate. PSYCHOSOCIAL RISK MANAGEMENT TABLE ACCORDING TO LEO26 PRIORITY (Only used for workplace psychosocial risk reports under the high score category. Circle employer plan of action according to LEO26 item priority) LEO26 Components Item Risk Management (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Job Support (JS) Role in the Organization 6, 8, 19 Job Support (JS) Relationship Between Friends 7, 13, 21 Job Support (JS) Organizational Culture 2, 10, 16, 22, 23 Work Demand (WD) Balance Work and Daily Life 3, 15 Work Demand (WD) Working Hours 4, 11, 18 51 15: APPENDIX 3: PRisMA Form 3 – Workplace Psychosocial Risk Reporting Comment: _______________________________________________________________________________________ ________________________________________________________________________________________ ______________________________________________________________________________________ Name of PTP : __________________________________________________________________ Signature : __________________________________________________________________ Date : __________________________________________________________________ Official Stamp : __________________________________________________________________ 52 15: APPENDIX 4: MSIC 2008 Industry Reference List 53 15: APPENDIX 5: First Schedule - Act A1648 “First Schedule [Subsection 1(3)] Non-Application: 1.Domestic employment in relation to a person who employs another, or is employed, as a domestic servant within the meaning of the Employment Act 1955 [Act 265]; 2. Armed Forces; 3. Work on board ships governed by the Merchant Shipping Ordinance 1952 [Ord. No. 70 of 1952], the Sabah Merchant Shipping Ordinance 1960 [Ord. No. 11 of 1960] or the Sarawak Merchant Shipping Ordinance 1960 [Ord. No. 2 of 1960]”. 54 15: APPENDIX 6: List of Contributors Thank you to the Department of Occupational Safety and Health (DOSH) for trusting the team of consultants & researchers from Universiti Teknologi MARA (UiTM) to complete this task. A wreath of appreciation to the management of UiTM and the faculty for the permission and approval given to carry out this project. The consulting team would also like to express their gratitude to the invited panel involved, and to those who were directly or indirectly involved in the preparation of this report. Drafting Commitee No. Name Position Organizations 1. Dewililah Sapriah Yosof Technical Specialist III Occupational Health Nurse National Institute of Occupational Safety and Health (NIOSH) 2. Ahmad Zaidin Othman Case Manager Social Security Organization (SOCSO) 3. Dr. Muhamad Ariff Muhamad Noordin Occupational Health Doctor National Institute of Occupational Safety and Health (NIOSH) 4. Zulkefli Ismail Occupational Safety and Health Officer Badanbas Sdn Bhd 5. Ts. Dr. Nur Azma Amin Senior Lecturer Universiti Kuala Lumpur 6. Haji Sulaiman Selamat Deputy Chief Psychological Officer UiTM Puncak Alam 7. Ts. Dr. Mohd Zubairy Shamsudin Assistant Professor Human Factors & Ergonomics / Occupational Safety and Health Kulliyyah Allied Health Sciences, International Islamic University, Kuantan 8. Dr. Shawaludin Husin Occupational Health Doctor MSOSH & Klinik Noridah 9. Prof. Dr. Krishna Gopal Rampal Professor, Occupational Health Universiti Cyberjaya 10. Dr. Hanif Farhan Mohd Rasdi Senior Lecturer Vocational Rehabilitation & Driving Rehabilitation Universiti Kebangsaan Malaysia, Kuala Lumpur 11. Mohd Shaharudin Saud Head of Quality, Safety and Occupational Health Division UiTM Puncak Alam 12. Ts. Dr. Siti Kartina Abdul Karim Senior Lecturer/Head of School UiTM Sarawak 13. Farul Adli Roslin Occupational Safety and Health Officer Pembangunan Ladang Hassan Sdn. Bhd. 14. Tengku Dr. Intan Baizura Tengku Jamaluddin Senior Clinical Lecturer UiTM Sungai Buloh 15. Lenty Ketit Anak Janting Assistant Medical Officer Rajah Charles Brooke Memorial Hospital 55 15: APPENDIX 6: List of Contributors No. Name Position Organizations 16. Ts. Siti Hajijah Ismail Assistant Science Officer UiTM Sarawak 17. Dr. Lim Chun Shen Medical Officer Sarawak Heart Centre 18. Dr. Joyoki Chen @ Joyce Chen Medical Officer Samarahan Division Health Office 19. Dr. Rohani Mat Bah Public Health Physician Sarawak State Health Department 20. Ishak Y Polli Regional Government P. O. Box 62273, 91128 Lahad Datu Sabah 21. K. S. Gobinath Kunalan Occupational Health Medical Officer Ministry of Health, Malaysia 22. Yuhanna Lipahnus Sustainability Clerk Lot 15&16, Kimbell Industrial Estate 23. Kashim Othman Employee Safety and Health Manager Kg. Bongkol, Pitas 24. Dr. Diana Katiman Medical Lecturer UiTM Sungai Buloh 25. Aina Shamsuriah Asbullah Manager BHIC Submarine Engineering Services Sdn. Bhd. 26. Tan Khern Wee Assistant Civil Engineer Special Project Team 2, JKR Malaysia 27. Cyril Jinusie IH Executive PETRONAS, Sabah 28. Mohd Hafiez Mat Husni Assistant Manager, Occupational Safety and Health Nexus Resort & Spa Karambunai 29. Jeremy Sherween Zabala Technician P.O Box 17291, 88873, Kota Kinabalu 30. Hermansa Mansur Occupational Safety and Health Officer Private Company 31. Ts. Rudy Petrus@ Mustapha Occupational Safety and Health Officer Sedafiat Sdn. Bhd. 32. Azlit Singh Gill A/L Ravinder Singh Manager Telekom Malaysia Bhd. 33. Mohd. Isa Husin Occupational Safety, Health & Environment Manager Sabah Energy Corporation Sdn. Bhd. 34. Dr. Tiong Min Lee Deputy Hospital Director Hospital Sentosa. 35. Huzainah Amshari Yuman Safety and Health Officer BHIC Submarine Engineering Services Sdn. Bhd. 56 15: APPENDIX 6: List of Contributors No. Name Position Organizations 36. Marratul Pakan Sustainability Manager Masih Jaya Sdn. Bhd. 37. Prof. Dr. Anselm Su Ting Occupational Health Doctor Universiti Malaysia Sarawak 38. Dr. Zulkifli M. Yunus Health, Safety and Environment Group GHSE PETRONAS 39. Dr. Amei Farina Abd Rashid Medical Consultant (Aviation) Klinik Afly Cyberjaya 40. Rosmawati Fiee Occupational Health Nurse Occupational Health Division 57 Department of Occupational Safety and Health (DOSH), Level 5 (Main Counter), Block D4, Complex D, Federal Government Administrative Centre, 62530 PUTRAJAYA Tel : 03-8886 5343 / 03-8886 5342 Fax : 03-8889 2443 Email : projkkp@mohr.gov.my