Working on the frontlines of the coronavirus pandemic day in and day out, health-care workers experienced significant mental-health challenges over the past two and a half years — and while the most acute phases of the pandemic may have passed, the sector is preparing for the psychological fallout.
Employers in the sector have responded proactively with improvements to their mental-health supports and streamlining their disability management programs to make accessing care easier for employees.
“Hopefully we have seen the worst of COVID now, but we have not seen the end of the mental-health impact as we return to our workplaces and deal with the crisis we have seen in the last two years,” said Chris Anderson, president of Medaca Health Group, during a panel discussion at Benefits Canada’s 2022 Mental Health Summit in November.
3sHealth, a non-profit in Saskatchewan with a legislative mandate to provide services to the province’s health system — including an employee benefits plan trust for employees of 75 health-care employers — has seen that firsthand.
During the pandemic, disability claims peaked in direct correlation with the peaks of each wave, said Alana Shearer-Kleefeld, 3sHealth’s vice-president of employee benefits. And with each successive wave, claims became increasingly complex.
At the beginning of the pandemic, 3sHealth received a lot of claims related to anxiety and underlying health conditions that spoke to fear of exposure to the virus, she said. But as the pandemic wore on, the organization fielded more claims related to addiction, post-traumatic stress disorder, workplace issues and chronic pain.
In the latter case, “nothing had changed physically in their condition, [but] what had changed is how they felt emotionally about working with that chronic pain every day,” said Shearer-Kleefeld, noting the organization is now seeing double the disability claims’ volume than before the pandemic.
At the Health Benefit Trust of Alberta, a benefits plan administrator owned by health-care employers in the province, mental-health conditions were a top driver of disability claims even before the pandemic, said Carolyn Chapman, organizational health consultant at Canada Life, which worked with the HBTA on its mental-health strategy.
Before the crisis, the HBTA offered psychiatric assessments through Medaca and pharmacogenetic testing so employees could quickly find the best medications for them through its disability management program. When the pandemic hit, the HBTA and Canada Life realized easy access to treatment would be critical and added virtual cognitive behavioural therapy.
“The funding for that was available through the disability program, so that when the individual returned to work they have access to their paramedical health benefits to support them with any future issues or ongoing [maintenance],” said Chapman.
Canada Life also added a consulting psychologist to its disability team to support the HBTA plan and provide insights into claims management. It now has a relationship with HumanisRx for pharmacist consultations for employees. “When an employee is identified by a case manager of having a complex medical condition — maybe mental health, chronic pain, maybe they’re on multiple medications — [the pharmacist] can provide us with a comprehensive assessment of all the potential and current drug therapy problems,” she said.
3sHealth’s work pre-pandemic to redesign its disability claims management meant plan members experienced a much smoother and more compassionate experience during the health crisis, said Shearer-Kleefeld.
The non-profit uses a “care call” to build relationships and trust with its members and gather information about their illness or injury and their functional abilities. It introduced a rehab and mental-health advisor into its team to support and advise its 13 in-house adjudicators on complex claims.
3sHealth also introduced an addiction treatment funding policy to support inpatient treatment. Shearer-Kleefeld said that was particularly valuable to the organization’s health-care worker members who could have the option to go out of province to receive care rather than risking running into their co-workers during their treatment.
It also improved its mental-health benefit to a $2,000 annual maximum and added Medaca as a mental-health assessment provider to support its claims decisions and to get plan members’ psychiatry treatment and a peer-to-peer consult between a Medaca psychiatrist and their general practitioner.
For plan sponsors looking to improve their mental-health strategies, Chapman suggested they first inventory their existing programs and determine whether their communications about those supports is effective. She also recommended setting up a wellness committee as a way to receive feedback and input on initiatives from multiple departments and employee groups, as well as introducing education for employees and particularly managers to reduce stigma.