Over the years, employers have done a lot to improve the health and safety of employees in the workplace—but the mental health side of the house has been left out, says Dr. Heather Stuart, a professor in the Department of Community Heath and Epidemiology at Queen’s University. Dr. Stuart spoke today at EAPAT’s session on Overcoming the Stigma of Mental Illness in the Workplace.
It’s only in the last few years that employers have started thinking about mental health in the workplace, she said. But the new focus is with good reason: 15% to 30% of us will experience a mental disorder during our working lives. And mental illness is among the most frequent causes of disability, she said.
There is also cost to consider. Though there’s not a lot of data in Canada on workplace costs, data from the European Union indicate that workplace disability is estimated at 3% to 4% of GDP. In the U.S., more workers are absent because of mental disability than physical disability.
In mental illness, there are two pathways that affect productivity, she explained. First is absenteeism (an employee is physically not at work and takes time off). More significant, however, is presenteeism, which is when an employee comes to work but has diminished productivity. Stuart pointed out that for every hour lost for an absent employee, add four hours lost for a present employee who is ill and not producing.
However, the problem is that many people with a mental illness do not seek help. In a small study conducted by Stuart, only one-third of workers with depression sought help in the form of a doctor, healthcare provider or employee assistance program. And 18% waited more than 10 years to seek help.
Stigma abounds
One of the root problems of mental illness is the fact that those with an illness are not disclosing their issue. This has a lot to do with the stigma attached to mental illness, said Stuart. “[Stigma] is much more than prejudicial attitudes.” There are various components to it: cognitive, emotional, behavioural and structural (e.g., someone might work in an organization that treats people with mental illness unfairly).
With an unfair work environment, there is also employment-related discrimination. Eighty percent of those with mental illness with employable skills don’t have a job; 20% of mentally ill workers employed in various organizations report discrimination. And 30% of those with mental illness in the U.S. were counselled to take jobs below their educational level (i.e., underemployed).
As for employers, according to research in the U.S., one in two employers would rarely employ someone with a mental illness, and one in four would dismiss someone for a previously undeclared psychiatric illness. “That’s blatantly illegal,” said Stuart. And one in three people were turned down for a job once their psychiatric status was known.
In the U.K., one in two employers admitted they would never hire someone with a diagnosis of depression for an executive position.
In Canada, there is workplace disability legislation, which imposes on employers a duty to make “reasonable accommodations” in order to accommodate an employee with a mental illness. For example, an employer might consider a more flexible work schedule, supported employment or part-time work.
However, Stuart added, the catch to the accommodation is that an employee must disclose that he or she has a mental illness. That’s often hard to do, simply because of work-related stereotypes.
Stuart pointed to the types of work-related stereotypes that people with mental illness face. Those with mental illness are considered…
- unemployable;
- unable to handle stress;
- unpredictable (can’t be sure they’ll show up for work);
- unreliable;
- untrustworthy;
- inappropriate in behaviour;
- unable to recover; and
- malingering (they’re deceitful, taking days off when they’re not sick, etc.).
What employers need to do
Stuart said employers have to think about changing corporate culture. In 2003, less than half of Fortune 100 companies in the U.S. had a workplace disability policy that expressly included people with mental illness.
They need to recognize that mental health issues are a legitimate work-related concern and develop prevention and promotion policies.
And employers need to provide managers with appropriate training and education to recognize that an employee is struggling. “You need to know how to read the symptoms,” Stuart explained.
“It’s the workplace stigma that’s undermined the ability to improve the mental health of workers,” she concluded. “Corporate cultures are going to be have to become stigma-free.”