584 Occupational Health Psychology
Figure 24.2 Fiscal years 1990 and 2000 “high risk” case management
appointments.
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Blue Collar (143 Clients) White Collar (154 Clients)Program, designed by Klunder and Scheibler, clinical social
workers were hired and deployed to base organizations with
the goal of identifying these individuals and attempting to
assist them in the transition process. These consultants acted
as case managers working with identi“ed members, helping
them set a path for transition, then ensuring their follow-up
with the outlined recommendations. The consultants were
available for crisis management as well as routine guidance
and assistance. This also visibly demonstrated senior
management concern for the employees and their families.
Figure 24.2 shows utilization charts for services over the crit-
ical period of the transition.
However, a number of barriers had to be overcome. These
seasoned professionals had to be age, gender, and ethnically
similar to the populations they served. Given the cultural
norms in the workforce, troubled individuals would have had
considerable resistance in dealing with a young counselor. A
more mature counselor would be seen as having a better un-
derstanding of life circumstances. The caseworkers were
strategically embedded throughout the industrial complex
with a priority to locations that were high on the RIF list.
Their of“ces were located in the work areas, and they made
daily rounds with frequent contact with the entire workforce
in their buildings. They built collaborative networks with
supervisors, union stewards, on-base providers, and workers
to facilitate referrals and working relationships. They con-
ducted aggressive outreach marketing activities to identify
and acquire high-risk employees for services. They consulted
with senior and mid-level management on individual worker
and workforce stabilization issues. Even though the clinical
director was the OHP psychologist, the TLAs were not iden-
ti“ed as being management, which greatly facilitated their
acceptance.
High-Risk Work Environment, Good ResultsIn the context of this high-risk work environment with dra-
matic change occurring daily, there was concern that serious
problems, such as suicide and workplace violence, might be-
come overtly manifest. This was a particular concern for the
at-risk employee population. The at-risk employee popula-
tion presented with very complicated personal and family
problems, and with little or no identi“ed plan of action to re-
solve them. Troubled employees with chronic performance
problems were facing layoffs without a realistic transition
plan. Individuals remained in denial despite RIFs, workforce
movements, and building closures. Employees experienced
job disidenti“cation when they were moved to a variety of
locations with the intent of helping them. Many workers de-
veloped or experienced exacerbation of existing physical
problems. The base occupational medicine clinic indicated
that more than 30% of the Kelly workforce did not have med-
ical insurance. TLAs were able to “ll a needed gap in support
services, especially for uninsured workers, and therefore
played a signi“cant role in facilitating a smoother transition
for the Kelly population.SuicidesThe three key results over the six-year closure process that
have been examined were suicides, workplace violence, and
labor grievance or complaint rates. The results are very af-
“rming of the comprehensive OHP strategy for the health of
this working population. While there was a degree of suicidal
ideation and intent, as reported by TLAs, swift and direct in-
tervention resulted in several saved lives. Only one suicide
was completed within the base population during the six-year
period, and that event occurred with a new employee who
entered the workforce under psychiatric care. The event
appeared to be totally unrelated to the work environment.
During much of this period, the U.S. Air Force was very
actively pursuing a suicide prevention program, which the
Centers for Disease Control and Prevention credited with a
“ve-year drop in suicide rates of 16 per 100,000 (1994) to
2.2 per 100,000 (1999), an over 80% decline. However, even
in this high-risk environment, the Kelly results were well
below the 1999 overall Air Force rates.Workplace ViolenceWhile there was some angry language, heated emotions, and
minor pushing and shoving on occasion, there was never a se-
rious physical altercation throughout the six-year period of
the transition, re-alignment, and closure process.