Job Stress

In 2015, Japan passed a law requiring businesses with 50 or more employees to offer workers an annual assessment — the “Stress Check” — which measures risk of stress and other mental health concerns based on three domains:

  • Psychosocial and other stressors in the work environment, including job demands, job control (autonomy), work intensity, and sense of purpose.
  • Mental and physical symptoms of stress like irritability, exhaustion, difficulty concentrating, musculoskeletal discomfort, difficulty sleeping.
  • Social support, including connection with supervisors, co-workers, and loved ones.

The Japanese government recommends their 57-question assessment tool, the Brief Job Stress Questionnaire (BJSQ). Take a look at the English version here. Employers can use alternative questionnaires, but they’re required to include the same domains — workplace stressors, symptoms, and support.

The law — designed to help prevent stress in response to an epidemic of stress-related death and disease — mandates that

  • Employees are given the results of their Stress Check.
  • Employees found to be at high-risk for potentially harmful stress are referred to a physician.
  • Employers modify stressful work conditions (such as schedules, work location, or responsibilities) in collaboration with high-risk employees’ physicians.
Japan Stress Check program flow

Stress Check process (click to enlarge)

The law encourages employers to improve the workplace environment based on analysis of their group’s data. Specific interventions aren’t prescribed, although models and case studies are available.

The law prohibits release of employees’ data to employers without the employee’s permission, and it prohibits discrimination based on Stress Check participation or results. Though employers are required to offer the Stress Check, workers aren’t required to participate.

No one’s advocating a program like this outside Japan, but it should evoke dialog among wellbeing professionals and enlighten how we view job stress.

  • Japan — like much of Europe, Canada, and the US’s NIOSH — recognizes that job stress is rooted in workplace risk factors: lack of autonomy, role ambiguity, job insecurity, lack of social support, excessive demands, harsh environments, inadequate rewards, work/life conflict, and unfair treatment.

The Stress Check questionnaire draws on a growing body of evidence showing that it does, indeed, identify people who are at high risk of mental health-related disability.

As for intervention… There’s a lot of experimentation to be done before we can definitively say what works. To date, evidence supports organizational change more than personal interventions to prevent worker stress.

Recently, a small initial study failed to demonstrate positive outcomes for either the questionnaire alone or for workplace interventions alone. However, the researchers reported:

Combining the annual stress survey with improvement in the psychosocial work environment can effectively reduce psychological distress.

Like it or hate it, the Stress Check program is innovative. We’re reminded that innovation is not always technology driven. We need innovators to follow Japan’s example and take a fresh look at our job stress paradigms.