Employers play a critical role in de-stigmatizing mental illness
Depression, anxiety and other mental illnesses cost Canadian businesses more than $50 billion a year in lost productivity, benefits costs, disability leaves and absenteeism, according to the Mental Health Commission of Canada. And that figure continues to rise, mostly because many people struggling with mental illness bear it alone and in silence—especially in the workplace. Canadians don’t seek support from their employers or colleagues because they fear the repercussions, such as losing their jobs or, worse, losing their professional reputations.
Mental illness has come to the forefront in recent years with the publication of the National Standard of Canada for Psychological Health and Safety in the Workplace and with more public figures—speed skater Clara Hughes and activist Margaret Trudeau, for example—speaking openly about their own struggles. Yet there is still a stigma attached to mental illness, and it’s this stigma that prevents people from seeking help.
Damaging Stereotypes
According to the Canadian Mental Health Association (CMHA), stigma is a result of negative stereotypes around mental illness that continue to be reinforced in the media, which often depict the mentally ill as violent and unpredictable. In the workplace, employees view colleagues living with mental health conditions with suspicion and question their capabilities, which can result in these employees being overlooked for promotions.
A 2007 Ipsos Reid study found that 79% of North American workers think people would hide the fact that they had a mental illness from their employers to avoid hurting potential career opportunities. Almost 50% believe that if an employee is absent as a result of his or her mental illness, he or she is likely to “get into trouble and maybe even fired.” And a survey conducted in the United States found that more than half of employers would be hesitant to hire a person who is mentally ill, while one-quarter would dismiss an employee who had not disclosed the illness. It’s not surprising, then, that the majority of people with a mental health condition keep quiet and don’t divulge their health status to their employers.
Our society has made progress on reducing the stigma attached to mental illness. People now openly discuss mental health, and employers are more aware of its organizational impact. Yet more still needs to be done to completely eradicate negativity and misinformation around what are usually treatable conditions—and employers have an important role to play. The best way to do this is to realize that those with mental illness are not other people; they are us: our mothers, our children, our colleagues, ourselves.
Mental illness is not rare or extraordinary. Almost one in five Canadians will suffer from a mental illness at some time in their lives, according to the CMHA. As with other illnesses, mental illnesses can be severe or mild and can improve or worsen. They can include schizophrenia, psychosis, bipolar disorder, post-traumatic stress disorder, depression, anxiety disorders, phobias, panic disorders and obsessive-compulsive behaviour. And they can strike anyone at any time.
Depression is the most prevalent mental illness. In fact, the World Health Organization has indicated that depression is one of the world’s leading causes of disability, with more than 350 million people of all ages currently living with the illness worldwide. Fortunately, depression is extremely responsive to treatment—usually medication, counselling or both. Once help is sought, 80% of people make positive improvements allowing them to return to their regular activities, according to the CMHA. Yet many people do not seek help: they think they will simply “snap out of it” or, because of the stigma, they are too embarrassed to ask for it.
The longer depression goes untreated, the harder it becomes to treat. Untreated depression can actually cause physical changes to the brain. Brain-imaging technologies—such as magnetic resonance imaging—have indicated that the parts of the brain involved in mood, thinking, sleep, appetite and behaviour look different in those who have depression, according to the National Institute of Mental Health. While classified as a mental illness, depression can also result in fatigue, aches and pains, headaches and digestive problems.
Depression is also striking younger and younger people: 3.2 million Canadians ages 12 to 19 are at risk for developing depression, according to the CMHA. In today’s increasingly competitive global economy, Canadian businesses cannot afford to lose skilled employees in their prime working years.
What the Numbers Say
The 2011 Conference Board of Canada study Building Mentally Healthy Workplaces reveals the extent and prevalence of mental health issues in the workplace. Of the more than 1,000 Canadians surveyed, 44% reported that they were currently experiencing (12%) or had previously experienced (32%) a mental health issue. (This was based on a broad definition that included excessive stress, anxiety, depression, burnout, addiction and substance abuse, mania, bipolar disorder and schizophrenia, among others.)
That surprising figure is behind escalating benefits costs and disability claims. In the 2011 Conference Board study, 78% of short-term disability claims and 67% of long-term disability claims in Canada were related to mental health issues. Canadian government figures show that more hospital days are used by people with mental illnesses than are used by people with cancer and heart disease combined. A report by the Canadian Alliance on Mental Illness and Mental Health stated that “depression will be the single most expensive cause of lost workplace productivity due to disability by 2020.” That’s just seven years away.
Erasing the Stigma
It’s not easy to change deeply entrenched attitudes toward mental illness, but employers can certainly make inroads with their workforce. Doing so requires a corporate-wide strategy involving leadership, managerial skills, workplace culture, and education and communication.
Leadership – Change begins at the top; therefore, endorsement and support from senior leaders is essential. Top management must demonstrate leadership not only in promoting good mental health but also in supporting employees who are experiencing mental health challenges. This can take many forms—from leading the initiative and being active in creating and implementing corporate-wide strategies, to assuming the role of corporate spokesperson(s) and regularly communicating goals and new initiatives. Senior managers can also speak about their own experiences with mental illness. Having successful, respected corporate leaders openly discuss the subject and their own experiences makes a powerful statement about inclusion and acceptance. Active endorsement and support from unions and other employee associations also helps transform ideas into action.
Managerial skills – Managers are on the front lines of organizational health and well-being. Not only are they able to identify productivity and behavioural issues early, they’re also instrumental in supporting and accommodating team members with physical and mental illnesses and challenges. Managers often set the tone for their team and directly influence levels of stigma. While some managers are well informed about mental health issues, they often feel ill-equipped to discuss these issues with employees. Many feel awkward or even skeptical regarding non-physical illness. Leadership training in understanding mental illness is key. The 2011 Conference Board study also reported that 44% of managers have had no training in dealing with mental health issues in the workplace. Providing appropriate and ongoing training for managers at all levels to help them deal with mental health issues and understand how they can guide employees to the appropriate resources is one of the most important initiatives that an organization can undertake. Most employee and family assistance programs (EFAPs) offer this training.
Workplace culture – Creating an organizational culture that is truly inclusive and supportive of all employees takes time but begins simply by asking a few questions. Is there a company-wide policy in place to promote good mental and physical health in the workplace? Do employees feel their immediate supervisor cares about their well-being, work/life balance and stress levels? In addition to preventive measures, there should be policies and protocols in place that support an employee with a mental illness to return to work or stay at work. The workplace offers many positive opportunities and resources that can help employees recover or cope better: a supportive social network, feelings of self-worth, and access to EFAPs, return-to-work support and other health and wellness programs.
Education and communication – Education is perhaps the most powerful weapon in fighting stereotypes or misinformation. Employers can increase mental health literacy through workshops, seminars, and lunch and learns, as well as through printed and web-based articles and personal stories. Managers need to encourage team members to participate in education and training sessions and can further show their commitment by attending these sessions with their direct reports. The company’s EFAP—as well as organizations such as the CMHA, the Mood Disorders Society of Canada and the Canadian Health Network—can also provide a wealth of materials and support.
In Canada’s healthcare system, individuals who seek care for mental health issues typically rely on an often-confusing array of providers, and navigating these providers to find appropriate care is a challenge. While mental illness is an increasing cost driver for employers, programs have not kept up with the spiralling needs of today’s employees.
The importance of robust mental health benefits as part of an organization’s overall approach to health will become increasingly important. Many employees find that getting help is just too hard, and some aren’t aware of the resources available to them. Employees need to know the benefits and services that their employer offers. This communication should be an ongoing part of an organization’s overall mental health benefits strategy. EFAPs, psychological and psychiatric consultations, mental health assessments, complex claims support from mental health professionals, and workplace facilitation and mediation programs are all elements of a comprehensive approach.
Finally, it’s important to note that workplace mental health initiatives need to be sustained and regularly refined over time. Leadership teams change, employees change, organizational objectives change—any company and its benefits program will look a lot different five or 10 years from now. Health and wellness initiatives need to change accordingly to remain effective and relevant. Companies, then, must commit to making mental health a permanent item on their healthy workplace agenda and work to eradicate the stigma once and for all.
Judith Plotkin is vice-president, strategic operations, with Homewood Human Solutions.
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