Mental health and HIV among call centre employees in the Philippines: Co-producing a workplace intervention using a systems approach.

呼叫中心在菲律宾是一个快速增长的行业。尽管薪酬丰厚，但呼叫中心的员工几乎无法控制自己的工作，必须定期与愤怒的客户打交道，还必须在时间压力下满足高要求。这些压力状况可能会导致精神疾病，这可能会影响他们的工作表现，以及他们是否会冒着健康风险，以及他们是否有积极的社会关系。心理健康状况不佳也会影响组织的表现；它可能导致生产率降低、病假增加和员工流失率上升。与此同时，菲律宾是世界上艾滋病毒流行增长最快的国家，由于高水平的无保护措施的性行为，呼叫中心的员工被认为处于危险之中。这些年轻劳动力的高压力和高可支配收入，再加上男男性行为者(MSM)比例相对较高，也被认为是艾滋病毒风险增加的原因。性身份、行为和艾滋病毒状况方面的耻辱和歧视都是导致精神疾病健康状况不佳的原因。之前的研究表明，心理健康状况不佳与艾滋病毒风险往往并存，而且两者都会使对方变得更糟，特别是在人们也经历耻辱和歧视等情况的情况下。出于这个原因，研究人员敦促将这两个健康问题结合在一起。有很多有效的方法来解决精神健康和减少工作场所中的艾滋病毒，但几乎没有做什么工作来将这些结合在一起，也没有做什么来解决LMIC呼叫中心的具体问题。这个项目的目的是了解工作场所的环境(或系统)如何影响心理健康和艾滋病毒风险。我们将与呼叫中心员工及其经理合作，了解他们的优先事项，并确定他们认为可以提供潜在解决方案的工作场所方面。在就这些解决方案达成一致后，我们将在工作场所尝试这些解决方案，并询问经理和雇主他们对解决这些问题的程度、实施这些解决方案的容易程度以及它们是否物有所值的看法。这些解决方案将需要考虑物理环境、工作文化和更广泛的社会影响，以确保它是可接受的，并易于长期实施。该项目将包括与员工和管理人员的研讨会，以及对员工和外部专家的采访。我们的目标将是提出一个最终的设计，呼叫中心以及行业和政府的利益相关者认为值得在更大范围内进行评估。我们还将与其他研究人员分享在企业环境中设计干预措施的方法的经验教训。

Call centres are a fast-growing industry in the Philippines. Although well-paid, call centre employees have little control over their work, must deal regularly with angry clients, and must meet high demands under time pressure. These stressful conditions can lead to mental ill-health which can affect their performance at work as well as whether they take risks with their health, and whether they have positive social relationships. Poor mental health can also affect how well the organisation performs; it can lead to lower productivity, increased sickness absence and higher staff turnover rates. At the same time, the Philippines has the fastest growing HIV epidemic in the world and call centre employees are believed to be at risk due to high levels of unprotected sexual activity. High-stress and high disposable income in this young workforce, combined with a relatively high proportion of men who have sex with men (MSM), are also thought to contribute to increased HIV risk. Stigma and discrimination around sexual identity, behaviour and HIV status are both contributors to poor mental ill health. Previous research has shown that poor mental health and HIV risk often exist together and each makes the other worse, particularly where people also experience things like stigma and discrimination. For this reason, researchers have urged that the two health issues should be tacked together. There are lots of effective ways to address mental health and reduce HIV in workplace settings but little work has been done to bring these together, and little has been done to address issues specific to call centres in LMIC. The aim of this project is to understand how the workplace setting (or system) shapes both mental health and HIV risk. We will work with call centre employees and their managers to understand their priorities and identify aspects of the workplace that they think could provide potential solutions. Having agreed on these solutions we will try them out in the workplace and ask managers and employers for their views on how well they address the issues, how easy they are to implement and whether they represent value for money. The solutions will need to consider the physical environment, working culture and wider social influences to ensure it is acceptable, and easy to deliver in the long-term. The project will involve workshops with employees and managers, as well as interviews with employees and outside experts. Our aim will be to come up with a final design that call centres and stakeholders in industry and government think would be worth evaluating on a wider scale. We will also share lessons with other researchers on methods for designing interventions in corporate settings.