29th Oct, 2020 Read time 7 minutes

ISO 45003 and the differences between psychological and physical health and safety

The new ISO standard which is due to be released in the summer of 2021 shifts the focus from physical safety to psychological health and safety. This move aims to apply some of the formal processes of managing standard safety in the workplace to the world of mental and psychological health.

Discussions on psychological health and safety with Anker and Marsh

Many are wondering what the standard will look like and how it will compare to other ISO standards of the past. HSE Network asked Dr. Tim Marsh and Karen Royle of safety consultancy Anker and Marsh what if there are any differences between physical and psychological health and safety and if these differences may be reflected in ISO 45003:

Tim Marsh: 

“There’s a distinction to be made between psychological health and safety generally and the emerging field covered in my joint paper with Jacqui Wilmshurst. Generally, we might think of anything covered by Warr’s ‘Vitamin model’ of occupational influence on Mental Health. (So level of control, autonomy, opportunity for skill use and/or development, degree and quality of interpersonal contact and the like).


More specifically, organisations are increasingly aware of, and effectively managing, specific environmental hazards to mental health that might fall under the broad heading of ‘possible trauma’. Outside of the Armed Forces and front line blue light work this used to be front-line war correspondents and the like. These days however it refers to the ever-increasing number of on-line content moderators.


As my article with Jacqui Wilmshurst covered however, there shouldn’t be a difference in the way these, or any other, issues are managed. They are just hazards that need to be properly risk assessed and managed in the standard way. By which, to be clear I mean by standard: objective, analytical, thorough, insightful, nuanced, long term, practical, dynamic, holistic, humane and subject to suitable and effective governance. All undertaken with the safety hierarchy in mind. (Just with fewer physical guards, locks and barriers).”

Karen Royle:

“The obvious answer is, physical health and safety is generally more visible.  Psychological health and safety is hidden.  Risks can jump out unexpectedly because you don’t know what is really going on in someone’s head; you don’t know they are thinking about something else or they are churning over a worry.  In such situations, psychological distractions can lead to over physical health and safety issues because of not concentrating.  

Equally, physical health and safety concerns can be managed from psychological distress; eg. the wires left to trip over are more likely to be noticed by someone in physical pain which is worsened by the fact they have to lift their leg higher to step over them.  

The two are very much interconnected.  

For me, it’s about what is your brain thinking about – where is your attention focused, and what is happening around you to help you manage that attention?  

Is your attention heightened to the physical health and safety risk because of a related worry (people are less likely to forget to pop the face mask on in the current climate than when there was less risk of catching a serious disease) or is it distracted to thinking about something else (eg. the fact their elderly parent has just been diagnosed with Covid-19)

So what helps?

Taking time to check in with people at the start of a task and having time to re-align the thinking ready to begin ….putting other thoughts to the side and setting the mind ready to do what it needs to do.  And this can be as simple as, thinking about the task on the way to the meeting, writing a note of other things on your mind to refer to later so they aren’t cluttering the brain as you work.  An athlete or swimmer uses the time on the starting line to think about how they will win the race, an actor prepares their entrance in the wings of the stage so they can enter the playfully in character.

Recognising when your brain is operating more in automated mode rather than proper thinking mode, can also help.  A swimmer is more likely to dive into a shallow pool on holiday whilst relaxed and not thinking about it, compared to when they are primed and ready for a specific race.  


Getting to know colleagues is important as it makes things a little easier to spot when things might not be as smooth or clear for them.  Do they seem quieter, more chatty, more negative etc.  And if you spot they are not focused or more fatigued, you can put more brainpower to watch out on their behalf.


Creating a safe space to talk, with non-judgemental responses is essential.  And this comes in two parts; the talking and the listening.

Getting more used to saying if you’re not ok takes practice – what words to use, how to say your feeling horrid without sounding like you’re being negative, critical or moaning

This requires a safe environment where people see it as more ‘normal’ to move on from the first polite, ‘hi, how are you’ and ‘I’m fine thanks’ to be able to say ….’ actually, you know what, I’m not – my heads in a spin, I’m overwhelmed at the moment, I feel really disgruntled’ etc.  

Doing this well doesn’t just depend on someone feeling comfortable enough to say it in the first instance, it also requires for the response to be heard and accepted without judgment.  Far too often we hear someone say this kind of thing, and we then,

  1. a) invert it to ourselves and either block the conversation with a quick response (…..’Oh, I know I’m overloaded too, it’ll get easier’) or allow our own emotions to be pulled into it (….‘I know that person really got my back up too’)


  1. b) place our own assumptions onto what people say, ‘you’re disgruntled? I’d better not ask much – I don’t want to churn the situation up, I haven’t got time to get into this’.  


If we focus less on the emotions and feelings in a statement, and we check in with ourselves regarding the assumptions we are making, taking time to understand what was actually said and meant, we can then help people explore a way out more easily.  Asking questions such as, ‘what do you mean ‘overwhelmed’ / ‘disgruntled’ …what would you like to have happened?”

Proper management of psychological safety is needed 

As shown in the responses from Tim and Karen, psychological safety is in some ways more complex than physical and requires separate processes and practices, but in many ways, the same fundamentals are true for both fields of practice. 

If you want further information on ISO 45003 and what the standard means for the profession our article from BSI discusses the nuances as the standard continues its path towards publication. 

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