Employee mental health is a growing challenge for employers, and it’s recognized as the No. 1 cause of lost productivity in the workplace. In fact, according to research by the National Committee for Quality Assurance, “depression results in more days of disability than chronic health conditions such as heart disease, hypertension and diabetes.”

Yet many organizations aren’t effectively addressing—or finding a solution to—the problem.

One of the most widely used strategies is the offering of employee assistance programs (EAPs), which have a long history of serving employees and employers alike. However, because mental health encompasses a large variety of conditions and associated symptoms, the response to mental health issues cannot be expected to fall to just one approach. A continuum of strategies is essential.

While EAPs are appropriate, there are also other, often related, approaches that employers must consider. These can range from information posted on websites to self-tests for depression and anxiety, through to individual treatments for these and other mental health conditions. But above all, integration with the workplace culture is key.

“We can buy a benefits plan, we can buy an EAP and disability and so on, but none of it is integrated,” says Telena Oussoren, director, pension and benefits, with Scotiabank, Total Rewards. “Progressive employers are trying to move that way, but we as an industry need to work together to develop this.”

“[Employers are]…fine with having EAPs, which put a lot of the onus on employees to self-identify and get help,” says Paula Allen, vice-president of organizational solutions and national practice leader, health consulting, with Morneau Shepell. “But there are organizational factors around stress, and it’s very difficult to get an organization to truly grasp what that means, and what they can do about it. That takes more corporate buy-in than anything else, because you’re talking about really taking a hard look at what culture, systems, leaders, risks and supports you have in place.”

In the case of depression—the most common mental health issue affecting workplaces—EAPs may be an excellent starting point, but it is essential to realize that they might not be sufficient. A proper course of cognitive behavioural therapy (CBT), which has been shown to be very effective for depression and other issues, may take between 12 and 16 sessions—or more. EAP entitlement of perhaps four to six sessions is not enough.

“Many therapies for depression risk being less effective if they are interrupted prematurely,” Gabrielle Bauer reported from the Benefits Canada annual Mental Health Summit on November 10. “In a pilot project, longer-term cognitive behavioural therapy yielded dramatic improvements in employee mental health” (emphasis added).

Longer-term interventions, such as CBT, even though time-limited, are often delivered by psychologists whose services are not covered by a provincial health plan (such as OHIP in Ontario). And while the cost of a course of CBT may seem expensive, in light of the success of such interventions, the opportunity cost is relatively low. Still, benefits plans are largely lacking when it comes to coverage for mental health services. This again brings up the issue of integration of health benefits: offering an EAP is a sound strategy, but unless integrated with other strategies, it may not suffice, especially for more serious mental health issues.

Depression is associated with a number of common medical conditions such as heart disease, and, according to the National Business Group on Health, “two decades of research show that persons with depression are at a greater risk for developing heart disease than healthy persons.”

The Employee Assistance Professional Association has identified eight distinct initiatives and/or activities that all EAPs provide; those most relevant to this discussion include the following:

  • referring clients for diagnosis, treatment and assistance, as well as offering case monitoring and follow-up services;
  • assisting organizations in establishing and maintaining effective relations with treatment and other service providers, and in managing provider contracts; and
  • providing consultation to organizations to encourage availability of employee access to health benefits covering medical and behavioural problems including, but not limited to, alcoholism, drug abuse and mental and emotional disorders.

While the most popular strategy for dealing with mental health in the workplace has generally been a reliance on EAPs (especially in larger organizations), a complete look at the organization’s initiatives—or lack thereof—is an employer’s best starting point. The organization should ask itself if it is getting full benefit from its current approaches and should examine what it offers employees, including mental health education and promotion, EAPs and linkages with providers that offer longer-term assistance, as well as its overall benefits plan design.

An organization’s comprehensive approach to dealing with workplace mental health not only is essential for employees but may also be the best way to improve the bottom line.

David Michaels is the CEO of The Clinic For Emotional Wellness Inc. in Vaughan, Ont. david.michaels@theclinicforemotionalwellness.com

Copyright © 2018 Transcontinental Media G.P. Originally published on benefitscanada.com

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