Mental health issues create significant workplace challenges from a cost and productivity standpoint. Benefits Canada’s 2013 Mental Health Summit explored new research, perspectives and tools to help employers help their employees.
Stress, anxiety, depression and other mental health issues have created a new reality—a “new normal”—for employers across Canada. And this new normal is taking a financial toll. According to the Mental Health Commission of Canada, the total economic burden of mental illness in the country is $51 billion annually, with $20 billion resulting from loss of workplace productivity.
But employers can better support employees struggling with mental health issues. All they need is input and help from other stakeholders.
Because there are still many barriers preventing people from receiving appropriate treatment—such as stigma, poor access to care, and lack of knowledge and support—“less than 20% of employees who develop depression actually seek help,” explained Heather Creighton, a consultant pharmacist with MHCSI (Managed Health Care Services Inc.). “Of that 20%, only half receive a correct diagnosis and treatment.” More startling yet, of those who receive a prescription for an antidepressant, 81% do not take it—and, of those who do, 48% do not stay on the medication long enough to achieve the full benefits.
Creighton described MHCSI’s two-year pilot program, which shows the effectiveness of a pharmacist-led collaborative disease state management (DSM) initiative in improving medication use and health outcomes. The program focuses on patient education and support. Now, at its halfway point, 83% of study participants report having a better understanding of their condition and their treatment, and 71% are taking their prescribed medication.
“The money to cover DSM is already there,” she added. “For every $1 spent on depression treatment, employers are already spending $2 on absenteeism and reduced productivity.” But it’s not only doctors and pharmacists who play a role in supporting employees on the road to mental wellness. Chris Camp, chair of the Halifax Professional Fire Fighters Benefits Trust, explained why its peer support program has been so successful.
“Peer support programs are preventative in nature and are designed to encourage people to seek assistance in the early stage of a problem or crisis,” he said. “Peers do not diagnose or treat. Instead, they help people navigate through the system to obtain professional support.”
The only costs involved are training the peer supporters in critical incident stress management (CISM), attending skills (the ability to focus your full attention on what someone is saying or doing), suicide intervention, post-traumatic stress and family-related issues, Camp added.
The results for Halifax Regional Municipality fire services have been earlier intervention—and, therefore, earlier treatment—improved morale and reduced staff turnover. “We’ve had only one LTD claim in the last six years,” he said. “And considering our profession, that’s pretty good.”
Let’s Get Functional
Louise Chénier, a senior research associate with The Conference Board of Canada, then shared the board’s latest research on depression in the workplace. More than 2,000 employees across Canada were surveyed, including 727 front-line managers.
One finding is that employees returning to work after a depression-related leave need more support. “They often continue to experience cognitive difficulties,” Chénier explained, adding that 95% may come back with memory problems, difficulty concentrating or difficulty making decisions. “Organizations need to think less [about] returning people to work and more about returning them to full functionality.”
Employers can provide a range of low-cost accommodations to help, she explained. These include offering flexible work hours and time off for counselling or doctors’ appointments; reducing distractions in the work area; creating goal-oriented workloads; job coaching; and referring the staff member to an employee and family assistance program for further help with stress management and other psychological care.
Karen Seward, president of Cira Medical Services, agreed. “So often, people can’t go back to where they were before,” she said. “The challenge for us is determining the right return-to-work supports for each individual so they can adapt to their new normal.”
While managers are an integral component of the process, Seward explained, a truly effective return-to-work plan needs to involve multiple stakeholders such as HR, occupational health professionals, attending physicians, specialized medical support, families, community resources—and, if applicable, unions.
Why should organizations invest more in return-to-work programs? Seward stated that, at any time, 8% to 12% of Canada’s workforce is off work due to illness or injury and receiving some type of compensation. That means, the average organization is spending more than $10.5 million per year in absence claims, she added.
Live Social and Learn
According to the Conference Board survey, 59% of employees believe their employers support people upon their return to work. “The not-so-good news is that managers were felt to be insensitive, unsympathetic and unsupportive,” said Chénier. “Employees reported that they were made to feel guilty [for] taking time off work and that they were ignored on their return. That’s because people feel uncomfortable addressing a mental health issue. Managers and colleagues need training on how to address such situations.”
In conjunction with Saint Mary’s University, Jennifer Dimoff, an occupational health consultant and co-founder of Dimoff & Kelloway Consulting, has developed one of the first scientifically evaluated, customizable mental health training programs specifically for managers. Dimoff explained that the training was initially created for Bell Aliant, which needed help with addressing significant increases in its mental health disability issues and the duration of claims. The company wanted a non-invasive, high-impact and cost-effective solution.
That solution was to help its leaders improve their mental health knowledge, increase their confidence about approaching employees on mental health issues and encourage them to promote positive mental health in their teams. And it was effective: two months after the training, 91% of the leaders reported using what they learned at least once a week. In addition, Bell Aliant had a 25% decline in mental health disability costs.
However, to truly reduce stigma and barriers to treatment, all employees need to understand mental health issues. Employers and providers have the opportunity to make a huge impact.
“Technology has made it possible for us to reach thousands—if not millions—of people to promote mental health interventions and share information,” said Dr. Scott Wallace, director, creative, social and digital media, with Homewood Health. “And social media and mobile health applications are becoming the normal way for people to access health information.”
Employers can help by establishing their own social media and mobile health presence to guide employees to reputable resources and mobile health applications, he explained, noting that these applications could also help with sharing information between the patient, doctor and disability manager to allow everyone to work together more effectively. “The power is in the hands of consumers,” he said. “They want better health information, so we need to build better tools.”
More Than Just Depression
Depression, stress and anxiety are not the only mental health issues having an adverse effect on today’s organizations. Dr. Martin A. Katzman, clinic director and staff psychiatrist with the S.T.A.R.T Clinic for Mood and Anxiety Disorders, presented the findings of an Ipsos Reid survey of 213 ADHD sufferers.
Doing such a study seems obvious, he said, but there are no data on the effects of ADHD at work. “And if we do not help people find the pathway to health, they cost everyone,” he added. “But the greatest cost is to the person with undiagnosed ADHD.”
Adults with undiagnosed ADHD change jobs with alarming regularity, lack concentration and focus, are impulsive, and often exhibit behavioural and emotional issues. They’re also prone to depression and other mental health disorders. In fact, 63% of those surveyed experienced depression, 58% reported anxiety and 22% had suffered drug or alcohol addiction.
“It’s all around us because it’s not recognized and, therefore, not addressed,” said Katzman. “They either get diagnosed and treated in childhood or don’t get treated at all. Instead, it destroys lives.” It’s clear that, where mental health is concerned, early diagnosis and intervention are the keys to bringing an employee back to full health. Practical tools, useful information and innovative strategies can further help organizations not only stem the rising tide of short- and long-term disability leaves but also create healthy, resilient and more productive workforces.
Moira Potter is a freelance writer based in Toronto. mopotter@rogers.com
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