Prevention Through Better Working Conditions

One of the fundamental tasks of accident insurance institutions is the prevention of occupational accidents and occupational diseases. Modern prevention strategies, however, increasingly recognize that workplace health extends beyond physical safety and must also address psychological well-being.

A particularly relevant challenge in Austria is the growing shortage of personnel in the care sector. Currently, approximately 121,000 people work in nursing and care professions, yet demographic developments indicate that around 51,100 additional workers will need to be recruited or replaced by 2030. By 2050, demand is expected to increase to approximately 196,000 care and support workers.

The care sector is heavily dominated by women, who account for more than 85% of the workforce. Furthermore, around half of these women are older than 45 years, placing a substantial proportion of employees in the age group most affected by menopause. Research suggests that more than 75% of women between the ages of 45 and 60 experience menopausal symptoms, many of which can affect both physical and mental well-being.

For women working in care professions, menopausal symptoms often occur alongside demanding working conditions. Shift work, high workloads, emotional strain, staff shortages, and physically demanding tasks already place considerable pressure on employees. Menopausal symptoms such as sleep disturbances, fatigue, anxiety, difficulties with concentration, and mood changes may further intensify these challenges.

The consequences are not only personal but also organisational. According to the “Meno Support Austria 2024” study, approximately 21% of women reduce their working hours during this phase of life, while 14.4% of women over the age of 55 consider leaving their profession altogether. At a time when healthcare systems are struggling with workforce shortages, retaining experienced employees has become increasingly important.

To address this issue, AUVA has launched a research project in cooperation with the Ludwig Boltzmann Institute focusing on age- and gender-sensitive working conditions in the care sector. The project aims to investigate which workplace factors create particular stress, how menopause is perceived and managed by colleagues and supervisors, and which support measures may be effective in maintaining employees’ health and professional participation.

The study consists of an extensive questionnaire distributed throughout participating healthcare institutions. It is aimed at all employees in the care sector regardless of age, gender, or position while maintaining a special focus on women experiencing menopause. To ensure broad participation, the questionnaire has been translated into many of the languages commonly spoken among care workers. Participating institutions include AUVA facilities, facilities of Austria’s Pension Insurance Institution (PV), and Hanusch Hospital of the Austrian Health Insurance Fund (ÖGK).

The findings will be used to develop practical guidelines for employers and occupational safety professionals. These guidelines will support workplace assessments that explicitly consider menopause-related factors and promote diversity-sensitive risk evaluations. Ultimately, the project seeks to improve working conditions, reduce health-related issues, prevent occupational diseases, and support mental well-being among care workers.

Although the project is still in its early stages and results are not yet available, it already demonstrates how an accident insurance institution can promote mental health through preventive action. By identifying psychosocial risk factors and supporting healthier working environments, accident insurance providers can contribute to retaining valuable staff and improving quality of life for employees.

Supporting Recovery After a School Shooting

A second example highlights the importance of psychological support following a traumatic event. Austria was confronted with a devastating school shooting in which a young man entered a school and killed ten people, including one teacher and nine students. Several others suffered gunshot injuries, while many additional pupils, teachers, and staff members were exposed to severe psychological trauma.

Under Austrian law, pupils and students are covered by statutory accident insurance during school-related activities. Consequently, accidents occurring in connection with school attendance are legally treated in a manner similar to occupational accidents. Importantly, this protection is not limited to physical injuries. Severe psychological shock resulting from a traumatic event can also qualify as a health consequence requiring support and treatment.

Immediately after the attack, police, emergency services, crisis psychologists, and other professionals arrived at the scene and initiated emergency measures. However, given the exceptional nature of the event, it quickly became clear that a coordinated long-term strategy would be necessary to address the psychological consequences for everyone affected.

Recognising this need, AUVA assumed a coordinating role. At the same time, it approved an emergency budget of €80,000 to finance immediate psychological assistance. Rather than becoming entangled in complex questions regarding the responsibilities of different social insurance institutions, AUVA prioritised rapid access to support services. Individuals affected by the tragedy did not have to make advance payments or wait for lengthy administrative procedures before receiving psychological care.

One of the most important measures involved the deployment of professional psychologists who conducted group sessions with pupils, teachers, and other school employees. These sessions took place during the final weeks of the school year, following the attack in June, and continued after the summer holidays when the new school year began.

In addition, individual psychotherapeutic support remained available throughout the summer. Affected persons were offered up to three personal assessment sessions to determine whether further treatment would be beneficial. Whenever necessary, long-term psychotherapy was initiated according to the applicable Austrian healthcare regulations.

The primary objective was to minimise the risk of long-term psychological consequences such as post-traumatic stress, anxiety disorders, depression, or difficulties returning to everyday life. By providing early intervention and continuous support, AUVA aimed to help students continue their education, teachers remain in the profession, and all affected individuals regain stability in their personal lives.

Particularly noteworthy was the decision to extend support beyond the strictly insured population. Bereavement counselling and psychological assistance were also offered to parents and siblings of those who had been killed. Although these family members were not directly covered by accident insurance in relation to school activities, their urgent need for professional support was recognised and addressed.

Conclusion

The examples of the menopause research project and the response to a school shooting demonstrate that accident insurance institutions can play a meaningful role in supporting mental health despite operating within a legally defined framework. Through prevention initiatives, they can identify emerging psychosocial risks and improve working conditions before serious health problems develop. Through effective accident treatment and rehabilitation measures, they can provide crucial psychological support following traumatic events.

The experience of AUVA illustrates that mental health is not separate from occupational safety and rehabilitation but an essential component of both. Whether helping care workers remain healthy and employed or assisting students and teachers in recovering from trauma, accident insurance institutions can make a substantial contribution to psychological well-being and long-term social participation. In an era where mental health challenges are becoming increasingly prominent, such approaches are likely to become ever more important. ●