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A holistic approach to health and wellbeing

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Report by Niamh McMahon, health and wellbeing specialist, RSSB


At RSSB the topic of employee health and wellbeing in the rail industry is not a new one but it has gained increasing attention in the past few years. Employers in all industries can no longer afford to ignore the benefits of investing in the health and wellbeing of their staff.

Across our members, we have a huge variety of employee roles and positions to consider from desk-based office workers to the site staff working on the tracks across a variety of shifts, day and night. No matter what the role, we know employee wellbeing needs to be considered and addressed.

Evidence suggests that taking a holistic behavioural change approach to individual health and wellbeing is key to long-term and sustainable changes. In 2013, the World Health Organisation published an article entitled “No physical health without mental health, lessons unlearned”  based on scientific evidence of the bidirectional relationship of mental illnesses, in particular anxiety and depression, and physical health outcomes.

In 2010, another study was published from the Institute of Psychiatry on the relationship between mental and physical health which concluded that many chronic illnesses cause higher depression rates but also that depression often precedes the onset of chronic illness.

The physiology of distress

Our immune system is like a thermostat. Most of the time it is turned down, but the gauge rises when we have an infection or experience psychological distress. Our bodies can respond in similar ways to both mental and physical stressors. Inflammation is a normal and healthy part of the immune response. It plays an important role in healing wounds and defending against foreign bodies. According to Prof Peter Jones, “inflammation may be a common mechanism that influences both our physical health and mental health”. People who are exposed to persistent stressors and adversity tend to have the thermostat permanently set a bit higher. It is thought that persistent inflammation in turn increases the risk of various mental and physical illnesses.

As well as triggering an immune response, psychological distress triggers our fight and flight response. Distress activates a part of our brain, called the amygdala, which prepares our inner caveman to either fight the threat or run away from the danger.

Physical responses include the release of hormones such as adrenaline and cortisol, which is why our heart beats more quickly and our body may become tense, ready for action. In the short-term, these changes help us cope, however the problem comes when the stressor is persistent. No one needs a sustained stream of cortisol and adrenaline to their hearts.

Of course, if you suffer from physical ill health, chronic inflammation (arthritis, psoriasis, Irritable Bowel Disease, etc.) the body’s stress response is likely to make it more challenging to maintain good mental health. For the many people who struggle with both poor mental and physical health, it can feel a bit chicken and egg.

The behavioural response to distress

We all respond to distress differently. Cortisol, our stress hormone, can increase appetite which instructs your body to absorb high energy foods. This makes sense if you are a caveman regularly battling sabretooth tigers but less sense if you are deskbound in an office.

When we feel particularly low, whatever the reason, we may find ourselves wanting to withdraw from the world. Withdrawing would help make sure cavemen avoided further harm, but in the modern world it can mean losing touch with the things that give you pleasure or natural pain relief, such as exercise. The action of withdrawing is thus causing more harm than good.

Distress can lead us to unhealthy lifestyle behaviours, while in turn, the unhealthy behaviours can increase our risk of poor physical health. This means people can often feel trapped in a vicious cycle. The good news is that because there’s so many factors involved, we have lots of potential points for intervention.

Working with our bodies in context

In order to take a holistic approach to health and wellbeing in rail, we must therefore consider all aspects of an individual’s health and wellbeing. Our bodies are complex machines and the brain and body interact with the environment. For example, if you decided you wanted to lose weight and started to exercise every day but your diet was very poor and full of junk food with little nutrient value then you are highly unlikely to get the long-term results you want. Likewise if someone suffers from anxiety they might start meditating but if they have a poor diet and are physically inactive again long-term results are less likely. An overall healthy balanced lifestyle is key, avoiding extremes and understanding what we need.

There has been a lot of great information available in the rail industry about nutrition, mental health, fatigue and the benefits of exercise for quite some time now and a lot of our members are doing great work in this field, but health and wellbeing is both a cultural and an individual issue and therefore needs to be addressed from various angles. We know that forcing information has little to no long-term affect and can often create resentment and disengagement. Everyone has their own story, their own level of knowledge, their own health experiences and values. All these factors contribute to what will work for them. One shoe does not fit all.

Understanding the synergistic relationship between our mental and physical health and that everyone has different needs is key to moving forward and hopefully achieving positive outcomes in this field.

What are we doing at RSSB?

It is an exciting time for health and wellbeing in rail. The health and wellbeing team at RSSB has recently expanded to cover employee wellbeing, mental health and occupational health. As a team we have a passion for making positive change, and our aim is to work closely together with our members and stakeholders to achieve significant and consistent results in all aspects of physical and mental health and wellbeing in the rail industry.

We have newly established a cross-industry Healthy Behaviours Subgroup and Mental Wellbeing Subgroup which is committed to improving holistic health and wellbeing in the industry. These groups feed into the Industry Health and Wellbeing Policy Group. Together we all want to drive positive change.

To find out more about the work RSSB is doing in this area, go to www.rssb.co.uk/Pages/health-and-wellbeing.aspx.