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发展的行业。尽管收入丰厚，但呼叫中心的员工对自己的工作几乎没有控制权，必须经常与愤怒的客户打交道，而且必须在时间压力下满足高要求。这些压力会导致精神疾病，从而影响他们的工作表现，以及他们是否会拿自己的健康冒险，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；这可能导致生产力下降、病假增加和员工流动率上升。与此同时，菲律宾是世界上艾滋病毒流行速度最快的国家，据信呼叫中心员工由于无保护的性活动水平很高而面临感染风险。年轻劳动力的高压力和高可支配收入，再加上男性与男性发生性关系（MSM）的比例相对较高，也被认为是增加艾滋病风险的原因。围绕性身份、性行为和艾滋病毒状况的污名化和歧视都是造成精神健康状况不佳的原因。先前的研究表明，不良的心理健康状况和艾滋病毒风险往往同时存在，相互加剧，特别是在人们还经历耻辱和歧视等事情的情况下。因此，研究人员敦促将这两个健康问题放在一起考虑。有许多有效的方法可以在工作场所解决心理健康问题和减少艾滋病毒，但很少有工作将这些方法结合在一起，也很少有工作解决低收入和中等收入国家呼叫中心特有的问题。该项目的目的是了解工作场所环境（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，并确定他们认为可能提供潜在解决方案的工作场所方面。在对这些解决方案达成一致后，我们将在工作场所试用这些解决方案，并询问经理和雇主对这些解决问题的效果、实施的难易程度以及它们是否物有所值的看法。解决方案需要考虑实际环境、工作文化和更广泛的社会影响，以确保它是可接受的，并且易于长期实施。该项目将包括与员工和经理的研讨会，以及与员工和外部专家的访谈。我们的目标是提出一个最终的设计方案，让呼叫中心、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。

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.