What is the cost of mental illness? About $14.4 billion annually, according to Health Canada, though the true price is much higher: lives are on the line. With depression forecasted to be the second-most common cause of disability by 2020, businesses of all sizes need to re-examine internal policies and procedures for identifying mental illness in the workplace and dealing with it.
It’s become a cliché: someone in the office is “on stress leave.” In medical terms, there’s no such thing, but the catch-all phrase masks a host of mental-health issues that have become a serious drag on productivity. With employees today expected to be available around the clock, the mounting pressures can quickly evolve from productive stress to a crippling disability.
The Canadian Mental Health Association estimates that half of the sick days in Canada are due to mental health problems. Even in laid-back B.C., where work/life balance is a mantra, depression and anxiety disorders are taking their toll on workplace productivity. It’s a global phenomenon: the World Health Organization has estimated that by 2020 depression will become the second most common cause of disability in the developed world, trailing cardiovascular disease. Health Canada has estimated that the economic burden of serious mental disorders in the public and private sectors amounts to $14.4 billion annually.
To shed light on workplace mental health, we brought together three experts: Jay-Ann Fordy, chief human resources officer at Coast Capital Savings; Margaret Tebbutt, workplace initiatives consultant for the Canadian Mental Health Association; and Dr. Merv Gilbert, psychologist, principal of Gilbert Acton Ltd. and consulting and adjunct professor at SFU.
When talking about workplace depression, do we really need to talk about mental health as a whole?
Margaret Tebbutt: Well, sometimes when we talk only about depression we’re limiting our conversation to one particular kind of mental health concern. And there are many others that can affect people in the workplace, be it anxiety disorders or bipolar disorder – various kinds of common mental disorders.
What is the most common mental health problem that you see in the workplace?
Jay-Ann Fordy: I think it manifests itself in stress. Whether that’s personal stress or workplace stress, that’s how it starts to manifest itself in the workplace in particular; people are feeling overloaded or they’ve got too much to do. Then the question is: How do you deal with that from a workplace perspective?
How do you recognize when natural, healthy stress turns into a destructive force?
Tebbutt: A lot of it is identifying the difference between occasional acute stress like, “We’re dealing with a deadline, we’ve gotta get the issue out” from chronic, ongoing stress. When every day, 365 days a year, there’s more to do than we can possibly accomplish with the resources we have: that’s a primary reason for good employees to leave that workplace. So not only may they be suffering some ill effects – physical or mental – from that ongoing chronic stress, but as a business, you may be losing some of your very best employees to more healthy workplaces.
Merv Gilbert: The three most common disorders to hit the workplace are depression, anxiety and risky substance use. Try as we might, whenever we talk about mental health, we end up talking about mental illness.
Is there still a stigma around mental illness that is affecting our ability to address and deal with it?
Tebbutt: Because of the stigma that’s been around mental illness for a long period of time, people will often say, “I’m feeling kind of stressed out,” because it’s kind of the safer language to use. People feel safer saying, “I’m stressed out,” rather than actually saying, “I have been diagnosed with depression” or “I’ve been diagnosed with an anxiety disorder.” If the person doesn’t feel safe in the workplace talking to their manager and seeking the kind of support that ought to be in place – if the language around the workplace is, “Oh, she’s gone to the psycho bin” or “He’s gone mental” – how safe will an employee feel in that regard?
Gilbert: Research suggests that the majority of folks with a diagnosed mental health disorder are not off work; they’re still at work. So where I think we need to put a lot more effort and attention – and this is what progressive organizations do – is helping people to stay at work in a safe and productive manner. And both of those are key words. It’s providing those supports, or what I like to call “small accommodations,” so people can stay at work and be productive. Work’s an important part of who we are; it’s part of our identity and our meaning.
How common is it for people to leave work because of a mental health problem?
Tebbutt: Well, some of the Towers Watson reports [a research company that tracks how Canadian companies handle employee mental health issues] are showing that anywhere up to 80 or 85 per cent of short-term and long-term disability claims are related to mental health concerns. Now that may be the primary reason, but it may also be a secondary reason going along with other kinds of health concerns. We know that if somebody’s dealing with cardiovascular problems, there’s likely to be depression. But we also know that if we’re dealing with depression, we’re more likely to have cardiovascular problems; it’s our whole body that’s engaged.
Fordy: Our research from the Center for Addiction and Mental Health says on any given week at least 500,000 employed Canadians are unable to work due to mental illness, including approximately 355,000 disability cases due to mental and/or behavioural disorders. So, it’s big.
Can an employer be proactive and address these issues with an employee head-on if they think the employee is having trouble?
Fordy: We’re just rolling out a webinar for our managers on how to have the conversation with employees. It could be a productivity issue, it could be feeling distracted, making errors, all the way to something more serious. For us, it’s all about creating that healthy place where people can talk about it. How do we make sure we’ve got managers who are empathetic, who care, who really inspire people to want to do their best and create that environment with the safety of having the conversation? I think that’s important.
Tebbutt: And, for example, through the Canadian Mental Health Association – and others do similar kinds of things – there is training that’s available for front-line
managers, as well as for HR folks in terms of how do you notice a change in behaviour or a change in functioning in the person in the workplace without jumping to assumptions as to what’s going on?
Gilbert: I also think you need to have individual programs. We all have the responsibility to look after our health and our psychological health, so providing programs and supports for individual employees to look after themselves in various ways is important.
We’ve been talking mostly about psychological health in the context of larger businesses that can offer long-term disability coverage. What can we say to small- business owners that don’t have these programs? How can they encourage a healthy workplace and handle potential problems?
Gilbert: It’s a valid point and we frequently hear that. I think small organizations – and we recognize that those are the backbone of the Canadian economy – have some advantages, actually. They can be more nimble, for one thing; they can have more flexibility in those kind of accommodations. “You need to go away at 4 o’clock on Tuesday because you’ve got a doctor’s appointment? Sure, we can cover it.” They’re also often closer to the ground. If I’ve got a staff with 50 people, 20 people, I’m more likely to know it if someone’s struggling. Whereas, in health care, for example, a nurse manager has a scope of 120 people, half of whom she has perhaps never met. . . . So they actually have some merits. [Small businesses] can reach out; they make better connections, in many cases, with the community; they can reach out to local organizations; they can partner together. There are things they can do.
Tebbutt: I would concur with what Merv’s saying in terms of being able to have that closer connection. It can be tough too, as a small business. You’ve got to meet payroll, you’ve got to handle your business and you may not have as much flexibility. So it can be challenging in terms of looking out. Maybe you want to ensure that you’re a member of your local chamber of commerce or some other kind of business association so that you can benefit perhaps from group plans that can help with EAP [employee assistance programs] or EFAP [employee family assistance programs] in a way that’s financially feasible for you.
Gilbert: I think a lot of organizations get it. If they’ve come out of the cave at all, they’re aware that this is a big deal, it’s been a big deal for some time, it’s not going away, it is not flavour-of-the-month in any way, shape or form. It’s going to be with us for some time. It’s a little bit akin to what was formerly the leading cause of disability – and still is in some sectors – musculoskeletal injury during the time when we had to “put our back into it.” Nowadays in the knowledge economy, it’s a different part of the anatomy.
Fordy: You can’t just go out and hire a person and expect what the standards might have been 20, 30, 40, 50 years ago. It is different. And then you’ve got a new workforce, that younger generation who, refreshingly, I think, are going to be a lot more open about what’s going on in their life. And I think if you look at the last 20 years since I’ve been in HR, we’ve been on the defensive on mental health for a lot of years and trying to get into proactivity. But that next generation is coming with expectations that this stuff exists, because they’ve dealt with it in high school. It’s so out there now, it’s so normal and all of the stigma attached with diversity issues and health issues and all that stuff is evaporating before they even get into the workplace. So I think it is time that we look at it from a strategic perspective and build on it.
Gilbert: I also think we need to pay more attention to how we design work: for a small employer or a large employer, to think about the job through a psychological lens, which we haven’t done. Most job descriptions don’t describe what people do for a living, particularly in the context of the psychological demands. The only place that I know of is the City of Toronto. It redesigned all its jobs in terms of psychological demands, the cognitive demands, the interpersonal demands. And that doesn’t mean screening everybody for mental health problems. It means looking at your attributes, what kind of additional training, what kind of additional support you might need to be successful in this position.