© Copyright 1998 Maclean Hunter Publishing Ltd. The following article first appeared in the November 1998 edition of BENEFITS CANADA magazine.

Taking the Sting Out of Stress

No employer is immune to the ravages of stress. But acting sooner rather than later can go a long way toward ensuring it doesn't start eating into your bottom line

By Sonya Felix

The symptoms ofwhat's been dubbed the plague of the '90s can begin innocuously enough--a few butterflies in the stomach, sweaty palms and racing thoughts when you get stuck in traffic on your way to work, worrying about whether you'll meet a deadline or agonizing over a business trip that will mean you'll miss your child's birthday. Such symptoms indicate a rush of adrenaline as your body responds to a stressful situation. It's a natural response to change that's helped us survive for eons, since the days of living in caves and using clubs to fight off predators.

"Everyone is stressed," says Toronto-based psychologist Richard Allon, who specializes in workplace stress. "We all have emotional and psychological symptoms as an adjustment to change and everyone's life is changing all the time." Change can be as trivial as the hassle of a traffic jam, or as monumental as getting fired or getting married. For most people, the response to stress is a good thing, stimulating and energizing them to deal with change.

But, for what seems to be a growing number of people, the relatively harmless symptoms of butterflies and sweaty palms are just the beginning. If the stressful situation continues or worsens and the person isn't able to control their response, the symptoms can become more severe--headaches, upset stomach, sleep loss, changes in appetite, irritability and inability to concentrate. At its most extreme, stress can lead to burn-out, a total body breakdown where the person can no longer function.

Why should an employer care about whether employees can cope with stress, especially that which comes from home rather than work? Stress-related symptoms cost big bucks in terms of absenteeism, lost productivity, poor customer service and escalating short- and long-term disability claims. According to Allon, a recent U.S. study estimated that stress in the workplace costs American employers $65 billion a year. Even a conservative translation of that figure to Canada adds up to a phenomenal amount of money.

No one, from white-collar executives to teachers, nurses, landscape gardeners and blue-collar factory workers, is either immune or more prone to stress, say the experts. "Stress is stress is stress," says Eli Bay, founder and director of Relaxation Response, a Toronto-based company that provides relaxation seminars for employers. "Whether it comes from home, the community or work, employers can't afford not to deal with the issue if they have any sense of their employees as an important resource."

A GROWING CONCERN

Although no one can say how many employees suffer from stress, the rapid escalation of disability claims for illness related to stress is a clear sign that stress levels are rising among the working population. Indeed, stress has become a big issue in the workplace. Says Doug Smeall, assistant vice-president of group life, health and disability at Sun Life of Canada in Toronto: "A few years ago stress-related claims made up 10% of total disability claims. Now it's as high as 30%. People seem to be having more difficulty coping with the demands of work and family."

Dave Johnston, vice-president of Great-West Life Assurance Co. in Winnipeg, agrees, adding that the jump in stress-related illness is due in part to more liberalized coverage of disabilities which came about with changes in human rights legislation in the late 1980s. As well, says Johnston, "there's general acceptance that the 1990s downsizing trend has led to more work- and personal-related stress. And there's greater comfort for individuals to come forward these days to talk about stress problems."

IDENTIFYING THE STRESSORS

There's no denying that stress has become a top concern among employers in virtually every industry. Nancy Gowan, health solutions director for Aetna Health in Toronto, says that her clients--which include companies in the manufacturing, banking, insurance and computer industries--all name stress as the number one issue they need to address."Everyone is finding it takes a lot more work to manage stress these days," says Gowan. "In the past, doing a few workshops on coping was thought to be enough. Now, stress is seen as more of a lifestyle and organizational thing. We still need to teach people to cope but the root causes of stress need to be addressed."

Identifying what's causing stress is as important to preventing stress-related illness as it is for managing a stress-related disability. Stress itself doesn't lead to disability, says Smeall at Sun Life. "We need to look at the more specific problems that keep a person from doing their job--inability to concentrate, difficulties sleeping and lack of focus." According to Smeall, asking more detailed questions about a claim can often help to understand the real sources of stress, including questions about management issues such as:

• Are processes understood?
• Is the workload too heavy?
• Is the employee getting enough training for the job? and
• Do employees feel they have enough control over their work?

The point here is to find some kind of accommodation in the workplace that will keep the person on the job or get them back to work as soon as possible. Sending someone off for a two- week rest to alleviate the symptoms of stress won't have much effect if the source of the stress is still there when the person returns to work. "Maybe someone is working 60 to 70 hours per week and that's causing stress," says Smeall. "Maybe the employer would be happy to have them working 40 hours. Sometimes it's as simple as negotiating with an employer to accommodate the necessary changes in the workplace."

Smeall also recommends that, when a situation appears troublesome, employers need to get involved immediately. Failure to intervene early just makes it more difficult to solve the problem later on. And the longer someone is away from work due to stress, the problem just grows. "Employers say it's a heck of a lot easier to do cognitive behavior therapy on the job before the issue becomes all consuming."

The bottom line: whether an em-ployee's stress is coming from work or home doesn't make a difference, because whatever the source may be, it affects what's happening on the job for that person.

THE ROLE OF MANAGERS

Most major companies have had employee assistance programs (EAPs) in place for years. With EAPs, the goal has been to help employees with various psychological and emotional problems, but they haven't necessarily had much effect on skyrocketing stress-related disability claims. "EAPs have made a significant contribution, but there are limits," says Jack Santa-Barbara, a psychologist and chief executive officer of CHC Working Well, an EAP provider based in Mississauga, Ont.

One of the problems with EAPs is that they reach a small percentage of the employee population. According to Santa-Barbara, the utilization rate is only about 7%, but it should be at 15% to 20% to reach enough employees to make a difference. "Most companies underpromote EAPs," he says.

To prevent the stress response from reaching the point of disability, employers need to teach employees how to:

• recognize signs of stress;
• get rid of unnecessary stressors in the workplace; and
• cope with stressors that are unchangeable.

"There are a lot of things individual employees and managers can do," says Santa-Barbara. "Some stressors in the workplace are simply part of the work environment, but there are others that aren't related to production and they are often created or ignored by managers."

Santa-Barbara cites the example of a major supermarket chain that did checks on employees to see how often they smiled at customers. Some female employees found that male customers sometimes misunderstood their smiles and that became a stressor in the workplace. "There are all kinds of things that go on in the workplace--harassment, bullying, hostility--that are unnecessary stressors. Anything people can do to each other can be done at work. People end up not wanting to go to work."

If an employee is suffering from stress, no matter what the cause, it's not enough to simply send them off to an EAP, says psychologist Allon. Solutions can range from offering to help with eldercare or childcare programs and flex time, to something as easy as allowing personal phone calls at work, all of which can help relieve employee stress. "Supervisors need to be more understanding and realize that greater expectations to work harder and longer can create conflicts with family responsibilities," says Allon. "The cost to an employer to rehire and retrain employees is incredible, so it's in their best interest, and cheaper, to look at what's happening in the workplace and do something about it."

One thing is certain, stress in the workplace or at home isn't going to go away. And disability claims related to stress will likely remain high. "I have to believe the increase will plateau eventually," says Smeall at Sun Life. "Day-by-day employers are more aware of the impact of stress on the workplace and many are beginning to set up services with respect to cognitive behavior therapy and counselling to deal with it. But, these services have to get to a certain point before these efforts pay-off." Right now, he adds, employers are more concerned with people who are off on long-term disability, because that's a real tangible cost. But tackling and treating stress-related problems before they get to that point, as well as putting a general emphasis on employee wellness, should begin to show results as time goes on.

Sonya Felix is a Toronto-based freelance writer and a regular contributor to BENEFITS CANADA.

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A HEAD START ON STRESS MANAGEMENT

Helping employees cope with stress has become part of the change process for companies like BC Tel, which went through large-scale corporate downsizing and restructuring a couple of years ago in response to shifts in the telecommunications industry. With one of the longest running employee assistance programs in the country (the programs were established 25 years ago), BC Tel already had a mechanism in place for dealing with employee stress. But three years ago, with a massive shakeup looming, the company decided to put a formal program in place to specifically handle an anticipated rise in employee stress.

Dr. Scott Wallace, clinical psychologist with BC Tel's corporate health services department, began putting together a stress program that emphasizes not only the traditional coping mechanisms of relaxation, diet and exercise, but also a cognitive behavior approach that helps people change their perceptions, attitudes and beliefs to see stressors as challenges rather than stress. The multi-model program includes a self-help workbook, personal presentations, videos, software, a five-step problem-solving process and a personalized action plan.

Teaching people to respond to stress in a positive way is important since stressors aren't going to go away. Says Wallace: "Workplace pressures will keep increasing. There won't be fewer mergers, acquisitions or downsizing in the near future and there won't be reduction in family/work conflicts either. A lot of things aren't going to change, so we have to change people's perception."

It makes sense--but does it work? According to Wallace, it's difficult to measure how successful the program has been so far, since confidentiality makes it impossible to know whether people who are absent because of stress-related illness sought stress counselling. "But, from talking to managers of groups about employees' comments, I've had anecdotal reports that people say they haven't taken time off that they otherwise would have."

So far, however, stress-related disability claims at BC Tel have continued to grow. "We had 15 more cases of stress-related disability claims this year over last year," Wallace says. "That's not so bad when you think we have 12,000 employees and there have been more even stresses in the workplace this year with more long-distance and local competition, and pressures on productivity to meet the needs of an expanding market."

The Romanow Commission has released its final report on the future of healthcare in Canada.

For Commissioner Romanow's recommendations, click here.

Click here for Senator Michael Kirby's report, "The Health of Canadians – The Federal Role: Recommendations for Reform."