Firstly, management must be convinced that there is a genuine and work-related problem. This attitude is gradually becoming easier to overcome as there is increasingly widespread recognition that stress has undesirable consequences for workers' health, and furthermore, presents costly economic hazards for businesses.

Stress is a hot health and safety topic internationally and in the UK; it is a "priority area" for the European Commission. The Trades Union Congress (TUC) designated stress a priority area for action, and has set up a team to develop guidelines on a practical approach to the identification, assessment and control of stress (TUC 1993), Most trade unions have now produced guidance on the subject (see Part 4, Contacts and resources).

The problem remains, how do you convince your employer that stress is a problem in your particular workplace? In the same way as you convince your employer that any other occupational hazard exists and has to be acted upon!

First you need the kind of information set out in Part 2 of this book. This general information, and any sector/industry specific information you can find, then has to be applied to your workplace.

Trade union Safety representatives have the legal right, under the Safety Representatives and Safety Committees (SRSC) Regulations 1978, "to investigate potential hazards at the workplace," this is one of the representatives' functions under SRSC Regulations 4 (1). So representatives can inspect for risk factors, and talk to workers about what they perceive to be workplace stressors. The point is to raise the issue at work at all levels. Talk to union members, organise meetings, get information from the union and other sources, give information to workers and start getting ideas from them about what the big problems are as they see them and what they think might be done to alleviate them. You may find it very useful to carry out a union survey to see what symptoms members are suffering and what they think the causes are. Start to develop some ideas for priority action, and proposals to put to management.

Raise the issue with management - you can point out any indications that stress exists, give examples of good practice from other companies, give them copies of articles, information from the trade union or the TUC, this book and so on. Use the Safety Committee if you have one, if you do not have one then see if you can set one up.

When you draw stress to management's' attention you can discuss their legal responsibilities under the Health and Safety at Work (HSW) Act and particularly under the Management of Health and Safety at Work (MHSW) Regulations which say that employers must carry out a risk assessment to evaluate risk factors in the workplace, who may be at risk and to what degree they may be affected by stress at work. If you can argue that there is any degree of risk to workers of occupational stress, or that a problem already exists, then the employer is obliged to carry out a written risk assessment and to adequately control the risk.

The second big problem is that, very often, if management accepts that workers are suffering work related stress, they will not treat this as an organisational, collective problem - instead they will offer stress counselling or stress management courses, any kind of individual solutions to help the poor unfortunates who can't cope. In other words, they want the workers to adapt so that they can cope with an unsatisfactory working environment. Counselling indicates a failure to control work-related stress. Counselling should only part of a stress policy, to help people who have already been affected, but the main emphasis should be on prevention, and counselling should form only a small part of the whole strategy to avoid and control stress.

Individual solutions do not work because they do not make any attempt to solve the problem. The International Labour Office (ILO) criticises "self appointed experts with pre-packaged programmes good for any occasion and situation, and remedial interventions focused on the effects rather than the causes of stress" (International Labour Office 1992). Their detailed evaluation of case histories concludes that the least useful approach was person-based interventions such as counselling and relaxation techniques. These were found to be ineffective even where employers had invested considerable time and resources. The goal is to improve the working environment, not just to patch up those casualties of it who remain in the job.

Professor Cox in his 1994 publication commissioned by the HSE says: "Practice in relation to the management of occupational stress is subject to a number of criticisms. First, too narrow a view has been taken of what constitutes stress management and there has been too strong a focus on 'caring for or curing' the individual."

"Second, much of what has been offered, even in this narrow respect, has either a weak theoretical base, or has been developed from outside occupational stress research."

"Third, there has been a tendency to treat the application of stress management strategies as a self contained action and divorce that application from any preceding process of problem diagnosis."

The European Commission Health and Safety Directorate recommends that "Interventions directed towards individuals should support them in crisis situations, enabling them to have more control over their lives and access to coping resources. Blaming the victim is not the right approach, so programmes directed towards the individual worker are never a substitute for more comprehensive strategies designed to tackle the problem of stress at source" (Hygeia 1992).

The consensus now, from most quarters, is that a "problem solving" preventive approach aimed at improving the working environment is what is required, rather than only trying to deal with symptoms experienced by individuals, important as that is as an additional activity.

So, the third and biggest hurdle then, is getting management to act, and to act appropriately.