Depression in the Workplace

B.C. companies are slowly making a move to properly recognize workplace depression.

B.C. companies are slowly making a move to properly recognize workplace depression.

Brenda fell into the deep, dark rabbit hole of depression at age 32, shortly after a stressed-out co-worker committed suicide. Like everyone in the headquarters of their Vancouver-based resource company, Brenda had been racking up extensive unpaid overtime for months to keep pace with a growing workload. Management’s unrealistic expectations had created a working environment where everyone was struggling just to stay afloat. She recalls how her former co-worker seemed unusually intense the day he stopped at her desk to say goodbye. “I asked if he had found another job. He said, ‘No, I just have to get out of here.’ I was concerned enough to tell someone in HR about what I thought was a very strange conversation. Two days later, they sat us down as a group and told us he had killed himself. They even brought in a counsellor to help us ‘cope,’ which seemed really bizarre, given that before then no one in management had cared what the added stress was doing to us.” The suicide was a tipping point for Brenda. Already struggling with a special project on top of her regular job, Brenda – a self-described detail-oriented perfectionist – began withdrawing from friends and family, sleeping less and crying constantly, unable to make even the smallest decision. When the very thought of getting up for work made her physically ill, she saw her GP, who diagnosed her depression, cleared her to take disability leave and made sure she got treatment. But her employer was far from supportive. Returning to work after her first depressive episode, she found herself at odds with a female supervisor, someone she describes as a judgmental “eye-roller” with little compassion. This relationship triggered a serious relapse, leading to thoughts of suicide, a short hospitalization and another stint on disability leave.

Today – thanks to a doctor-supervised regimen, including counselling, a healthy lifestyle emphasizing exercise and nutrition, and a stabilizing cocktail of four antidepressant medications – Brenda is once again, at age 50, a fully functioning member of the workforce. Her new employer, Coast Capital Savings Credit Union, is fully committed to reducing the stigma around mental illness, treating it as any other serious disease and training its managers to recognize the signs and symptoms of depression while directing those at risk to help through the company’s employee assistance program. “There have been times when I really couldn’t imagine saying that I love my job and the people I work with,” says Brenda, “but now I do.” [pagebreak]

Mental health in B.C.

Take a good look around your place of work; depression is almost certainly affecting someone on your team. According to B.C.’s Ministry of Health, one in five British Columbians, or approximately 882,000 people, will experience some form of mental health disorder this year, most likely depression or anxiety. Besides the tragedy of shattered lives and wasted human potential, depression takes an enormous toll on Canada’s economy: $51 billion a year, states the Toronto-based Centre for Addiction and Mental Health, with 40 per cent of disability claims and sick days in Canada the result of mental illness. Globally, the World Health Organization estimates that by 2020, depression will be the leading cause of disability. In May a study by the Alberta-based Institute of Health Economics published in the Canadian Journal of Psychiatry found Canada lags behind most developed countries in the amount of money it spends treating mental illness. (On a positive note, B.C. topped the list for provincial spending.) Our federal and provincial governments are starting to get the message – most notably in 2007 with the creation of the Canadian Mental Health Commission, chaired by former senator Michael Kirby. For the first time, Canada has a high-level national body supported by government (but arm’s length from it) charged with improving and standardizing care for Canadians dealing with mental illness, with a special emphasis on how depression affects aboriginal people, children and the workplace.

“Eighty-three per cent of surveyed Canadians admitted showing up for work while sick or exhausted an average of six times in the past year.”

Dramatic statistics and government initiatives aside, most Canadian workers know more about cancer, heart disease and HIV-AIDS – even global warming – than they do about mental illness. Not too long ago, we thought depression was synonymous with desperate housewives and sensitive poets; only now are we connecting the dots between depression and that hushed-up family suicide, alcoholic neighbour or withdrawn co-worker, quietly fired after his performance slipped. Indeed, scientists themselves don’t know much more about what causes depression; it’s a complex disorder with many causes, some physical and some psychological, and affects both sexes equally. But we do know that the workplace can play a role in contributing to the development of depression. A report recently commissioned by Desjardins Financial Security shows the extent to which workplaces serve as incubators for mental health problems: 83 per cent of surveyed Canadians admitted showing up for work while sick or exhausted an average of six times in the past year; 89 per cent said they believe stress-related problems are on the rise within their organization. Canadians work some of the longest hours in the industrialized world, according to the Organisation for Economic Co-operation and Development – almost seven weeks more per year than do French and German workers. Because we spend so much time at work, and its stressors often push susceptible people and those with existing depression symptoms into crisis, it’s the perfect place to spot emerging mental health problems – and to encourage sufferers to seek professional help.

Depression in the workplace

Margaret Tebbutt’s depression surfaced with a vengeance at age 50, at the peak of a 25-year career working for the Vancouver office of a federal government agency. She found herself struggling to concentrate and relate to her colleagues. At her lowest point, she recalls spending 15 minutes crying in her car each morning before she could don her “professional mask” and walk into the office building. Tebbutt is typical of people suffering from depression: her condition was simmering below the surface for years before it was correctly diagnosed. “In my case, it was the culmination of a lot of things over a long period of time: work, personal and family. I was very good at covering it up, but when I hit my low point people began to notice my increasing isolation and the fact that I wasn’t talking.” Convinced to seek help by friends and family, Tebbutt briefly returned to work for a year in another role before experiencing a serious relapse. Since taking early retirement in 2005 and focusing on her recovery, Tebbutt has put her experience to good use. Today she is self-employed, managing the Canadian Mental Health Association’s Mental Health Works initiative in B.C. and travelling constantly, giving presentations and workshops from Prince George to Vancouver on the importance of creating a mentally healthy workplace. Her expertise arms managers with the skills and confidence to discuss mental illness with employees and develop realistic, workable accommodation strategies to help people with depression successfully stay at work and return to work. Last year she and her fellow trainers took this message to more than 1,000 people at 51 workshops. Sessions cost anywhere from $800 to $4,000 and are tailored to organizations large and small. Tebbutt reminds her audiences that B.C. is facing a chronic labour shortage, so a healthy workplace is essential for companies that want to be considered an employer of choice. Younger workers entering the job market value organizations that endorse a healthy work/life balance and demand positive, respectful working relationships. That’s why creating a mentally (as well as physically) healthy workplace should be top of mind for any organization concerned about recruitment and retention. [pagebreak]

Creating a healthier workplace culture

Much of the leadership in creating a healthier Canadian workplace culture is coming from the public health-care sector, where depressed and anxious health-care employees – arguably working in some of the highest-stress working environments – can prove a real threat to patient safety. Among the first to creatively tackle the issue of workplace depression is B.C.’s Provincial Health Services Authority, which manages B.C. Children’s Hospital, BC Transplant, and B.C. Mental Health and Addiction Services (BCMHAS), the agency responsible for providing a wide range of provincial mental health services. In 2005 the authority developed a strategy designed to improve employee and organizational health and support system-wide change, based on a B.C. auditor general’s 2004 report on healthy workplaces. It included initiatives such as an employee health survey, web-based self-assessment programs and comprehensive management training, says Peter Coleridge, BCMHAS vice-president of education and population health. Future plans include better screening for depression, periodic health monitoring for employees identified as being high-risk and improved support for workers who return to the job following a disability leave. As part of this employee wellness initiative, BCMHAS worked with academics at SFU’s Centre for Applied Research in Mental Health and Addiction (CARMHA) to design and promote a useful new self-care manual, Antidepressant Skills at Work: Dealing With Mood Problems in the Workplace, which can be ordered in bulk as a training tool. While not intended to replace treatment, the workbook may be helpful to anyone at risk of developing depression, those who already have a diagnosis or concerned partners, friends, colleagues and supervisors. According to its authors, it is the first publication of its kind in North America to offer an “antidepressant skills rather than antidepressant pills” approach to managing depression in the workplace. In the private sector, Coast Capital Savings and London Drugs Ltd. are considered leaders when it comes to championing workplace mental health, but other B.C. firms are starting to answer the call. When Pacific Blue Cross Health Benefits Society – which recently received a Worklife BC Award of Merit for promoting work/life balance within its 709-strong workforce – discovered through an in-house health assessment that stress, where depression is an important contributor, was its No. 1 employee health risk factor, it decided to get the facts, educate staff and work on reducing the stigma around mental illness.

Health and wellness leaders

At a recent lunch session put together by Pacific Blue Cross, the Canadian Mental Health Association’s Tebbutt spoke to 90 “people leaders,” including union representatives and shop stewards. “It was exceptionally open and frank,” says Sinden Malinowski, Pacific Blue Cross’s program manager of health and wellness. “One of our managers volunteered to tell her own story, which left everyone else free to talk about experiences in their family and in the workplace. We learned from our own manager’s example that people do recover from depression and, with help and support from leaders and co-workers, can be highly productive.” Management’s increased awareness and compassion is already having a trickle-down effect throughout the workforce, adds Malinowski, demonstrating that the company is serious about making mental health awareness, education and accommodation a permanent component of its corporate wellness program. But public and private employers with progressive leadership, effective employee assistance programs and decent training budgets for creating mentally healthy workplaces are far from the norm. While most people do recover and return to work after bouts of mental illness, relatively few companies are truly accommodating – reducing or changing someone’s workload or, if necessary, finding them another role. Fewer still reach out to help their employees before they reach a critical breaking point. Most employees interviewed for a 2007 survey conducted by the Great-West Life Centre for Mental Health in the Workplace said the workplace is where they are least likely to get support – which is probably why 64 per cent of those reporting mental health problems say they prefer to keep their condition to themselves. Lloyd Craig wants to end the need for secrecy. The president and CEO of Coast Capital Savings embraced the cause of workplace mental health after his 25-year-old son Gavin committed suicide in 2001 after a lengthy struggle with depression. Craig is the driving force behind the BC Business and Economic Roundtable on Mental Health – an alliance of government agencies, private-sector firms and labour organizations committed to creating mentally healthy workplaces – which is credited with putting the issue of employee mental health on the corporate agenda and convincing B.C. executives that it’s a serious business issue. His initial goals were lofty: to increase awareness of mental illness among employers and mobilize them into action, to ensure that physicians are better equipped to recognize and treat depression, and to raise cash toward putting some of the brightest brains to work on new depression management strategies and treatments. He admits it has been an uphill battle siphoning private donations and government funding away from other compelling causes. But over time – with support from Premier Gordon Campbell, who he says has embraced the cause – Craig has managed not only to find funding for a chair in depression research at UBC, but also to establish an Institute of Mental Health (now working in concert with UBC’s Brain Research Centre and Mood Disorder Centre). Craig says that B.C. companies have been relatively slow to do the spade work, but he’s optimistic even more employers will come to understand the potential ROI. “When we get to a point where the workplace supervisor or family doctor or employee can see someone who is clinically depressed and say, ‘Jack is suffering from a brain illness and needs help,’ and not, ‘Jack is a loser and should give his head a shake,’ then we will know that we are making progress,” he says. Meanwhile, Craig is determined to continue playing the role of Jiminy Cricket: the voice of conscience on the shoulder of his corporate counterparts, nagging them to invest in a mentally healthy B.C. workforce. He believes that the best way to fight corporate denial is with honesty and hard data. “My advice to organizations that want to address workplace depression is, start and learn as you go. Read about and study the issue. Above all, be a thoughtful and caring employer, always bearing in mind that the whole person comes to work every day.”