Trauma, Power, and Psychological Safety: Understanding the Mental Health Impact of Workplace Bullying

AAIM Recommendations to Promote Equity in the Clerkship Clinical Learning Environment

Although companies are required to implement countermeasures against workplace harassment, their effectiveness has not been verified. Therefore, in this study, we compared employees' awareness of the primary preventive measures or organizational climate and the prevalence of harassment in each company. A total of 68 companies in Japan (with a total of approximately 20,000 employees) were targeted. Harassment countermeasures were measured using seven items. Power (11 items), sexual (7 items), maternity (2 items), paternity (2 items), care (1 item), and gender harassment (1 item) were measured. Organizational climate was measured using 10 items comprising subcategories, such as civility, psychological safety, and role clarity. The percentage of employee recognition of anti-harassment measures and organizational climate was divided into three groups (high, medium, and low), and the prevalence of each type of harassment and employees' recognition of changes in the workplace were compared using the Kruskal-Wallis test or ANOVA. In companies where more than 70% of the employees were aware that their company had implemented questionnaire surveys to ascertain the working environment, by displaying posters or providing training along with the establishment of a group-wide general and a compliance consultation service, the prevalence of power and sexual harassment was lower than in companies with lower awareness. However, no difference in the prevalence of power harassment by the employee recognition level could be confirmed with the dissemination of messages by top management, establishment of rules through employment regulations, and the establishment of a consultation service in the company. Regarding organizational climate, the incidence of power and sexual harassment was lower in companies where more than 80% of employees perceived high levels of civility, psychological safety, and role clarity. In addition, the higher the percentage of employees who were aware of the harassment prevention measures implemented by the company, the higher the percentage of employees who felt favorable changes in themselves, their surroundings, and their workplace. The harassment rate tended to be lower in companies where more employees were aware of the implementation of anti-harassment measures. The fact that the rate of harassment was lower in companies where there was role clarity and many employees felt psychologically safe suggests that measures focusing on the organizational climate may also be effective in preventing harassment.

Background: Psychological safety and occupational well-being among nurses and healthcare teams have emerged as urgent priorities in the face of escalating work overload, psychological distress, and moral injury in contemporary healthcare environments. This scoping review maps and synthesizes the scientific literature on psychological safety and well-being in the workplace among nursing professionals, with a particular focus on empirical findings, theoretical contributions, and practical applications. Materials and Methods: This scoping review followed the PRISMA-ScR guidelines and was guided by the PCC framework, which comprises the following components: Population (nurses and nursing teams), Concept (psychological safety and well-being at work), and Context (healthcare settings). Four major databases (PsycINFO, PubMed, Scopus, and Web of Science) were searched. After screening and eligibility assessment, 13 empirical studies were included. Results: Thematic analysis of the included studies identified four principal areas of emphasis: the effectiveness of interventions and organizational characteristics on well-being outcomes; perceptions of psychological safety and workplace climate; prevalence and predictors of emotional exhaustion and burnout; and the impact of long-term occupational stressors on psychosocial safety climate. Psychological safety has been consistently identified as a protective factor against burnout and emotional exhaustion; however, its promotion is hindered by structural barriers, leadership practices, and contextual variability. Most studies relied on cross-sectional designs and convenience samples, highlighting methodological limitations and the need for more longitudinal and interventionbased research. Conclusion: Psychological safety is a foundational element for nurses’ well-being and effective healthcare delivery. Integrating psychological safety into institutional policies, leadership development, and workplace culture is essential for building supportive environments. Future research should prioritize mixed-methods and intervention studies, develop context-sensitive measurement tools, and address structural and cultural barriers to implementation

Behaving safely under pressure: The effects of job demands, resources, and safety climate on employee physical and psychosocial safety behavior

In China's multi-ethnic regions, the phenomenon of workplace bullying can be compared to a mental shackle, which inhibits the work enthusiasm of the bullied, makes the bullied feel depressed, frustrated, and other negative feelings, and makes many employees miserable. This study aimed to develop a correlation between workplace bullying, employees' work withdrawal behavior, and psychological safety in China's multi-ethnic regions. The data collection for this study primarily involved gathering information. through questionnaires from 357 employees within 42 Yunnan-listed enterprises in China's multi-ethnic regions. All statistical data, including frequency, proportion, average, and variability measures, were analyzed using a software tool designed to process statistical information. The finding indicated there exists a direct correlation amongst workplace bullying and employees' work withdrawal behavior in China's multi-ethnic regions. Incorporating psychological safety into the model, subsequent mediation effect testing reveals that there is a partial mediating role of psychological safety in the correlation among workplace bullying and employees' work withdrawal behavior. This research contributes to the existing theoretical investigation on the correlation among workplace bullying, employees' work withdrawal behavior, and their psychological safety in China's multi-ethnic regions. Additionally, it explores how psychological safety can mediate these effects. Furthermore, this study offers valuable insights for enterprises operating in China's multi-ethnic regions by providing practical strategies for human resource management and conflict reduction within organizations.

Background/Objectives: The aim of this study was to describe and examine the relationships among elements of infection prevention practices, the care environment, psychological safety, and safety climate in adult medical surgical units in the wake of the COVID-19 pandemic. Methods: Nurses in adult inpatient medical surgical units in the northeast were surveyed electronically. Each self-rated their infection prevention practices and elements of the care environment in their primary work unit. They were also asked to rate a series of questions regarding how psychologically safe they felt on their units as well as the overall patient safety climate. Results: A total of 259 nurses responded (52% response rate) to the survey. Overall psychological safety was rated neutrally among respondents, with a rating of 3.5 (1 being the lowest and 5 being the highest). Respondents reported better ratings of the safety climate on their unit (4.0) but also identified areas for improvement. Eight of twelve infection prevention practices were correlated with higher safety climate scores and ten were correlated with higher psychological safety scores. Nine of ten environmental factors were correlated with higher safety climate and higher psychological safety scores. Conclusions: Both psychological safety and patient safety climate are related to nurse self-ratings of performance of infection prevention practices. Similarly, the care environment nurses work in has important implications for psychological safety and patient safety. It is essential for nursing leadership to act as a steward in these areas to build a higher quality care environment for nurses and patients alike.

Safety voice has become a popular research topic in the organizational safety field because it helps to prevent accidents. A good safety climate and psychological safety can motivate employees to actively express their ideas about safety, but the specific mechanisms of safety climate and psychological safety, on safety voice, are not yet clear. Based on the “environment-subject cognition-behavior” triadic interaction model of social cognitive theory, this paper explores the relationship between safety climate and safety voice, and the mediating role of psychological safety. We collected questionnaires and conducted data analysis of the valid questionnaires using analytical methods such as hierarchical regression, stepwise regression, and the bootstrap sampling method. We found that safety climate significantly and positively influenced safety voice, and psychological safety played a mediating role between safety climate and safety voice, which strengthened the positive relationship between them. From the research results, it was clear that to stimulate employees to express safety voice behavior, organizations should strive to create a good safety climate and pay attention to building employees’ psychological safety. The findings of this paper provide useful insights for the management of employee safety voice behavior in enterprises.

In 2025, industry-wide collaboration through the IOGP and WHO led to a global consensus on mandatory psychological safety indicators in HSE audits. ADNOC's 2024-2025 pilot programs have shown a 45% increase in help-seeking behaviors and a 38% reduction in stigma around mental health disclosures among offshore workers. The Oil & Gas industry operates in high-pressure, high-risk environments where physical safety is prioritized, often at the expense of mental well-being. However, research shows that workpla& hearce harassment, chronic stress, and psychological distress significantly impact operational safety, workforce retention, and, in extreme cases, self-harm and suicide. According to the International Labour Organization (ILO), one in five workers worldwide experiences workplace harassment, while the World Health Organization (WHO) links over 700,000 suicide deaths annually to workplace-related mental health struggles. Within the ADNOC Group and other leading energy companies, significant efforts have been made to improve HSE culture, workforce engagement, and psychological safety, yet mental well-being and harassment prevention remain underrepresented in traditional safety frameworks. This paper explores how unchecked workplace harassment ranging from verbal aggression and discrimination to retaliation against safety whistleblowers can escalate into severe psychological distress. It includes the structure of a framework for early intervention, mental well-being support, and suicide prevention, developed around three key pillars: Psychological Assessment of Managers & Supervisors - Implementing emotional intelligence (EI)-based evaluations, implicit bias testing, and stress management training to identify high-risk leadership behaviors and equip managers with mental health literacy.AI-Driven Early Detection & Support Systems - Utilizing AI-powered behavioral analytics, sentiment analysis, and digital well-being surveys to detect patterns of distress, isolation, and declining mental health before they escalate.Multi-Tiered Support Networks - Establishing peer-led advocacy programs, mental health first responders, and confidential crisis counseling services, with an emphasis on offshore, remote, and rotational workers who face heightened psychological isolation. This study integrates real-world data and case studies from Oil & Gas companies, focusing on: Industry-Wide Data Analysis -mental health statistics from WHO, ILO, IOGP, and ADNOC's workforce well-being initiatives.Workplace Harassment and Mental Health Surveys -surveys across ADNOC Group, upstream, downstream, and EPC operations to assess the prevalence of workplace harassment and its impact on psychological well-being.Psychological Profiling of Leaders - psychometric assessments of supervisors and managers to measure EI, bias awareness, and stress tolerance, identifying patterns that correlate with toxic workplace cultures.Pilot Implementation of AI-Driven Detection Systems -machine-learning-based sentiment analysis tools and anonymous mental health check-ins to monitor early warning signs of distress and harassment-linked psychological decline.Initial findings indicated that:Workers in offshore, rotational, and high-risk roles report higher stress, anxiety, and burnout levels, with one in three employees experiencing some form of workplace harassment.Low psychological safety correlates with increased operational risks, leading to higher incident rates, reduced safety compliance, and increased absenteeism.Psychological assessment of managers helps identify toxic leadership traits early, allowing intervention through training, coaching, and targeted leadership development programs.Confidential peer-support networks and AI-driven early warning systems significantly reduce mental health stigma, encourage early intervention, and improve employee well-being outcomes. For ADNOC and other Oil & Gas companies to create a mentally resilient workforce, mental well-being must be integrated as a core pillar of HSE and ESG governance. Beyond traditional safety metrics, organizations must recognize psychological safety as a direct contributor to operational excellence. This paper highlights how proactive intervention strategies can reduce workplace harassment, mitigate mental health risks, and ultimately save lives. To embed mental well-being and suicide prevention into corporate HSE, HR, and ESG strategies, the following recommendations are proposed: Mandatory Psychological Safety Training - Equip managers and supervisors with mental health literacy, de-escalation skills, and active intervention techniques.Regular Psychological Assessments - Implement quarterly EI-based evaluations for leadership teams to monitor workplace culture and stress impact.Early Intervention & AI-Based Monitoring - Deploy AI-powered behavioral analytics and anonymous well-being check-ins to detect and address emerging distress signals.24/7 Support & Crisis Networks - Establish dedicated mental health response teams, peer advocates, and emergency counseling services tailored for offshore and rotational workforces.Integration into ADNOC's ESG and HSE Reporting - Embed mental well-being indicators into HSE dashboards and ADNOC's ESG frameworks, ensuring accountability, transparency, and continuous improvement.Industry Collaboration & Knowledge Sharing - Promote cross-sector learning at ADIPEC and ADNOC- hosted knowledge-sharing forums, encouraging best-practice adoption across the Oil & Gas industry.

To examine the association between components of safety climate and psychosocial hazards with safe work behaviours and test the moderating effects of psychosocial hazards on the safety climate-safety performance relationships. The effects of a strong safety climate on safety performance are well cited, however, the conditions that have an impact on this relationship warrant attention. While the psychosocial hazards commonly reported by nurses are predictors of well-being and job attitudes, evidence suggests that these may also place boundaries on the effects of safety climate on safe work practices. This study used a cross-sectional design to collect data from 146 nurses. Participants were recruited through convenience sampling and snowball sampling methods in 2017. Nurses completed an online questionnaire and received a $5 e-gift card as compensation. SPSS v.23 and PROCESS v3.0 were used to analyse the data. A strong safety climate was positively associated with nurses' safety performance. While psychosocial hazards did not predict safety performance, they did moderate the safety climate-performance relationship. High levels of perceived stressors weakened the association between promoting two-way safety communication, the use and implementation of procedures to promote safe work practices and management's endorsement of health and safety with safe work performance. The positive effects of safety climate on nurses' safety performance are contingent on the levels of psychosocial hazards nurses experience. When aiming to improve safety performance among nurses, it is important for efforts to also focus on the psychosocial conditions of the work environment.

BackgroundPsychological safety is a team-based phenomenon whereby group members are empowered to ask questions, take appropriate risks, admit mistakes, propose novel ideas, and candidly voice concerns. Growing research supports the benefits of psychological safety in healthcare and education for patient safety, learning, and innovation. However, there is a paucity of research on how to create psychological safety, especially within academic medicine. To meet this need, the present study describes and evaluates a multi-year, medical school-wide psychological safety initiative.MethodsWe created, implemented, and assessed a multi-pronged psychological safety initiative including educational training sessions, departmental champions, videos, infographics, and targeted training for medical school leaders. Employees’ perceptions of psychological safety at both the departmental and institutional levels were assessed annually. The impact of educational training sessions was quantified by post-session surveys.ResultsDeidentified employee surveys revealed a statistically significant increase in departmental psychological safety between the first and second annual surveys. Perceived psychological safety remained lower at the institution-wide level than at the departmental level. No significant differences in psychological safety were observed based on gender, position, or employment length. Post-educational training session surveys showed that the sessions significantly increased knowledge of the topic as well as motivation to create a culture of psychological safety within the medical school.ConclusionsThis study establishes an evidence-based method for increasing psychological safety within medical school departments and serves as a template for other health professions schools seeking to promote psychological safety. Training leadership, faculty, and staff is an important first step towards creating a culture of psychological safety for everyone, including trainees.

Perceived Impact of Affect Labeling and Social Sharing in Healthcare: Insights from a Pilot Study and Opportunities for Future Investigation

The tourism and hospitality industry, well-known as a people-oriented industry, is not immune to the adverse outcomes of workplace bullying. This paper explores the darker side of the tourism and hospitality sector by investigating workplace bullying and its potential impact on shaping employee well-being. Specifically, the study explores how feedback avoidance can mediate the relationship between information flow and employee well-being and how psychological safety can moderate the relationship between information flow and employee well-being in bullying contexts. Using a quantitative-methods approach, the paper analyzed survey data from 341 employees at five-star hotels in Sharm El-Sheikh, Egypt, with structural equation modelling (PLS-SEM program). The findings indicated that the spread of information about workplace bullying promotes the feelings of stress among employees which negatively affects their wellbeing in the workplace. Additionally, feedback avoidance as a mediator was found to foster the harmful impacts of bullying. Conversely, psychological safety as a moderator functioned as a protective element, mitigating the negative influence of workplace bullying on employees' well-being. This paper enhanced our understanding of the dark side of the hospitality industry, specifically workplace bullying, by highlighting the key role of information dynamics about bullying in the workplace and the role of psychological safety in shaping overall employee well-being.

530: Pregnant women are inconsistent in their disclosure of physical, sexual, and emotional abuse

The social awareness of workplace bullying and harassment to prevent and eradicate it is rising according to enforced workplace harassment bans, such as the Labor Standard Act, amended in July 2019. However, there is no legal basis for the post-relief system and procedure for bullying and harassment damages in current laws that regulate workplace harassment, such as the Labor Standard Act. Since the enforcement of the law, many studies have emphasized the proactive prevention of workplace harassment. However, problems related to workplace harassment have continued to arise since the enforcement of the workplace harassment ban. Consequently, the need is increasing for the post-relief of victims due to workplace harassment.BR Basically, workplaces autonomously render their judgments, responses, and actions regarding workplace bullying and harassment. However, if the dissatisfied party files a lawsuit in a judicial institution, quick relief and restoration should be provided to the victim by first preparing a post-judgment and remedial procedure in the administrative agency considering the money and time required for litigation. This will become an important issue in the workplace harassment ban system.BR Correspondingly, this work examined the cases of Japan and Australia. Both countries’ legal systems regulate workplace harassment and a relief system. In Japan, workplace harassment is regulated under the Act on Comprehensively Advancing Labor Measures, Stabilizing the Employment of Workers, and Enriching Workers’ Vocational Lives. Furthermore, victims can receive post-relief through mediation from regional labor bureaus and regional labor relations commissions under the Act on Promoting the Resolution of Individual Labor-Related Disputes. Workplace bullying is also regulated in Australia under the Fair Labor Standards Act, and victims can seek post-relief through arbitration by the Fair Labor Commission.BR Hence, the relief system and procedures for workplace harassment must be legislated. Moreover, the administrative relief system should be improved so that post-relief from workplace harassment can be achieved through administrative agencies, such as the Labor Relations Commission. In addition, it will be crucial for local employment and labor offices and labor inspectors to strengthen and reconsider their roles in redressing the damages caused by workplace harassment.

Objective:To explore infection preventionists’ perceptions of hospital leadership support for infection prevention and control programs during the coronavirus disease 2019 (COVID-19) pandemic and relationships with individual perceptions of burnout, psychological safety, and safety climate.Design:Cross-sectional survey, administered April through December 2021.Setting:Random sample of non-federal acute-care hospitals in the United States.Participants:Lead infection preventionists.Results:We received responses from 415 of 881 infection preventionists, representing a response rate of 47%. Among respondents, 64% reported very good to excellent hospital leadership support for their infection prevention and control program. However, 49% reported feeling burned out from their work. Also, ∼30% responded positively for all 7 psychological safety questions and were deemed to have “high psychological safety,” and 76% responded positively to the 2 safety climate questions and were deemed to have a “high safety climate.” Our results indicate an association between strong hospital leadership support and lower burnout (IRR, 0.61; 95% CI, 0.50–0.74), higher perceptions of psychological safety (IRR, 3.20; 95% CI, 2.00–5.10), and a corresponding 1.2 increase in safety climate on an ascending Likert scale from 1 to 10 (β, 1.21; 95% CI, 0.93–1.49).Conclusions:Our national survey provides evidence that hospital leadership support may have helped infection preventionists avoid burnout and increase perceptions of psychological safety and safety climate during the COVID-19 pandemic. These findings aid in identifying factors that promote the well-being of infection preventionists and enhance the quality and safety of patient care.