Comparing sexual harassment from clients or customers to harassment from other employees

New research published in BMC Public Health explores whether the negative effects of workplace sexual harassment, specifically risk of depression, differs depending on whether the perpetrator is a client/ customer or another employee. Here to tell us about the research and why this distinction matters is Dr Maj Britt Dahl Nielsen, author of the study.

Sexual harassment at work includes unwanted verbal, non-verbal and physical sexual behaviors. Previous research shows that sexual harassment can lead to decreased job satisfaction and lower mental health, including more depressive symptoms.

In 2015, we started a research project focusing specifically on sexual harassment conducted by customers and clients (including patients). The research project included a cross sectional study on the relation between sexual harassment and depressive symptoms. The study draws on data from 7,603 Danish employees.

Why is this relevant? The phenomenon has received very little attention in research and practice, although clients and customers are more likely to be the source of sexual harassment.

Among the 7,603 employees in our study, 2.4% (180) reported exposure to sexual harassment from clients or customers during the last 12 months. In comparison, 1.0% (79) were harassed by other employees (including colleagues, supervisors and subordinates).

The prevalence was markedly higher among women in care work with 152 out 2,191 (6.9%) reporting exposure to sexual harassment from clients or customers.

To me these numbers underline the need to investigate sexual harassment by clients and patients further. The question is – are we talking about the same phenomenon? Or does it matter who the perpetrator is?

Compared to employees who were not harassed, employees harassed by clients or customers scored 2.05 points higher on the major depression Inventory.

One of our primary research questions was therefore to examine if the negative effects depend on whether the perpetrator is a client /customer or another employee.

The analyses revealed two important findings. First, compared to employees who were not harassed, employees harassed by clients or customers scored 2.05 points higher on the major depression Inventory (MDI) – a self-reported mood questionnaire that generates a diagnosis of depression and an estimate of symptom severity. Scores of 20 points or more are considered as an indicator for a probable depression.

Because we measured depression and exposure to sexual harassment at the same time, we cannot draw conclusions on cause and effect. Nevertheless, the findings support the notion that sexual harassment from clients and customers is associated with more depressive symptoms.

Second, much to our surprise, employees harassed by other employees scored 2.45 points higher on the MDI compared to employees who had experienced sexual harassment by clients or customers.

In my opinion, these findings underline a need to consider sexual harassment by clients/customers and sexual harassment by other employees as two distinct types of harassment.

As part of the research project, we have also conducted a qualitative study on sexual harassment in care work. Findings from this suggests that sexual harassment from patients is a taboo, and that employees consider the harassment an inherent part of their job.

In many instances patients do not harass the employees deliberately and cannot be held accountable for their actions, for instance when the inappropriate sexual behaviors is a result of cognitive impairment.

The qualitative study also showed, that -in practice, separating between intentional and unintentional harassment is complex and not straightforward. This therefore constitutes a specific dilemma for employees exposed to sexual harassment from patients.

In conclusion, I find that it is prudent to put sexual harassment from customers and clients on the agenda – especially in the workplace. We need to break the taboo and stop normalizing sexual harassment by patients as a part of the job.

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