Canada’s HR executives are increasingly aware of the impact of mental illness in the workplace, according to a Mercer and Canadian Mental Health Alliance survey – but those in top management are not always aware of the problem. Improving employees’ mental well-being is all the more necessary at a time of cost crisis and grim statistics.

Mental illness goes by many names in today’s workplace – depression, anxiety, stress, nervous disorders – but whatever we call it, there’s no question that it dramatically affects Canadian businesses. Indeed, Canada’s HR professionals cite alarming trends and challenges in dealing with the mental well-being of their employee populations, and the statistics are not encouraging.

For example, 35 million workdays are lost annually in Canada due to mental illness, according to the Global Business and Economic Roundtable on Mental Health, while the overall cost of mental illness to the Canadian economy has been estimated at CAD$51 billion a year by the Public Health Agency of Canada. More to the point, disability claims attributable to mental illness are the fastest-growing category of disability costs in Canada, said a 2006 report of the Standing Senate Committee on Social Affairs, Science and Technology. And the World Health Organization estimates that by the year 2020, depression will rank second as a leading cause of disability on a global basis.

To better grasp the impact of workplace mental health and to help codify what actions employers should take, Mercer partnered with the Canadian Alliance on Mental Illness and Mental Health, inviting public- and private-sector employers across Canada to take part in an online survey addressing mental health in the workplace. Conducted in the spring of 2008, the study surveyed 452 organizations, with 85% of respondents identifying themselves as HR professionals. (In this survey, mental health is defined as a balance of mental, emotional, physical and spiritual health and well-being. Mental illness relates to a medical condition involving thoughts, perceptions and feelings that is serious enough to affect day-to-day functioning.)

Not surprisingly, 79% of participants reported that mental health issues have increased in importance compared to 3 to 5 years ago, while 66% of them indicated that mental health is on their top 10 list of HR priorities (20% reported that mental health is among their top three priorities). These responses were spread across all industries and employer sizes.

Executive champions needed

Despite the high priority that HR leaders attach to mental health, they reported a gap in the awareness of the issue:

• 73% of respondents indicated that there is at least some level of awareness of mental health concerns among senior executives,
• only 13% of respondents reported their senior leadership as having strong awareness of the impact of mental health issues on the organization.

Of the companies that reported strong awareness in their senior ranks, more than 60% stated that this was achieved due to an existing senior champion.

Going forward, 25% of organizations with some or no senior executive awareness have no plans to improve the situation and around 45% plan to improve through education and information sessions. The corporate mindset needs to transform to one of action, tasking senior executives with implementing best practices in the workplace.

Senior executive awareness of the impact of mental health on the workplace is critical to gaining the resources and investment needed to improve employee mental well-being and to support employees in their recovery and return to work after experiencing a mental illness. An important way to gain leadership buy-in is to build a quantitative business case to demonstrate the impact on the business.

However, fewer than 20% of respondents intend to do this, and only 22% of respondents measure the impact of mental health in the workplace. Of those that do, the top 2 measures reported are :

• disability claims statistics (91%)
• employee assistance program usage (85%) followed by
• sick day usage (57%) and
• health plan usage (53%).

There may also be a serious disconnect when it comes to appreciating the extent of mental health problems in general. When asked about the prevalence of mental illness in their workplaces, 46% of respondents estimated that 5% or fewer of their employees experience mental illness in a year. But respondents may be underestimating the prevalence of mental illness, given that a recent study estimated that 12% of the adult population in Canada suffers from mental illness in any one year⁽¹⁾. A further study showed that 8% of employees take medications related to mental health conditions.⁽²⁾

Key risk factors

There are many risk factors related to mental illness, many of which do not involve the workplace. However, there are certain factors that do. These include:

• Lack of social supports at work
• Increasing job demands
• Being treated unfairly by a supervisor

Given the workplace factors that affect mental health, the survey sought input from respondents and found that:

• 55% reported that employee workloads and responsibilities have increased quite a bit (38%) or significantly (17%).
• Only 12% of respondents reported significant or quite a bit of improvement in the balance of workload, while 45% reported some improvement.
• A minority (31% of respondents) reported that there is a strong social network in the workplace.

These results point to the need to address workload balance and improvement in workplace-based social supports as proactive measures to support mental health.

Barriers to success

The top 2 barriers addressing workplace mental health, as reported by the survey respondents, were:

• Employee perception and stigma related to mental health (60%)
• Lack of front-line manager awareness (54%)

These results reveal significant barriers due to the stigma that is attached to mental health issues among employees and their supervisors. While some initiatives have been implemented – stronger education, improved awareness and targeted programs – supports need to be introduced to achieve equal and fair treatment of employees with mental illness. 57%of respondents reported that mental health issues are not treated by front-line managers on an equal basis with physical health issues.

The front-line supervisor plays a central role and requires appropriate tools and resources to be most effective. Half of respondents report that employees should go to their supervisors for help with mental health issues, and 54% of respondents report that the role of the supervisor is to identify employees who need assistance. Survey respondents indicated that the role of the supervisor extends to making referrals to EAP providers and HR, making decisions, and providing accommodations.

Only 3% believe that their supervisors are very well-equipped to do those things, and more than 50% identified their organizations’ supervisors as poorly or not at all equipped for their roles. A significant portion (27%) of survey respondents indicated that their supervisors have no defined role in addressing mental health issues in the workplace.

Action plans

What specific actions can improve this scenario? The survey offers some clear guidance.

• Increasing their EAP services
• Inscreasing resources for disability case management
• training and awareness

When asked about actions taken over the past two years to address mental health in the workplace and to provide their opinion on the effectiveness of these actions, 59% reported increasing their EAP services, and 95% of them judged that action as somewhat to very effective. As for increasing resources for disability case management, 40% of respondents reported taking this action, and again, 95% of them felt it was somewhat to very effective.

While survey respondents found that training and awareness were effective, it was, however, not as effective as increasing the EAP services and resources dedicated to disability case management. Although an equivalent 95%of respondents found the action somewhat or very effective, only 8% found workshops very effective, in contrast to 31% for increased EAP services and 35% for increased resources for disability case management.

In the participants’ opinions, increasing EAP services and increasing the resources dedicated to disability case management were considered to be very effective solutions compared to the other choices provided. However, only a minority of respondents who did not report taking these actions in the past two years have plans to take these actions in the next two years.

On a more encouraging note, 54% of respondents plan to train their managers over the next two years, while 70% of those that have already implemented training programs plan to add more. And 48% are planning employee workshops to address mental health awareness, with 45% planning to offer workshops to address job-stress factors. 

While the survey affirms that a number of Canadian organizations are making real strides in addressing mental health challenges, there is still a lot to be done. Companies must help overcome the stigma associated with mental illness, recognize the breadth of mental illness in the workplace, determine how to best support and accommodate employees at work, clarify the role of the supervisor and ensure that the right tools and supports are in place for supervisors to make a difference. Better management of employee workloads and improving the level of social supports at work are also important.

It’s also critical for Canada’s HR practitioners to ensure that they are able to measure the impact of mental health in the workplace, gain senior-level buy-in to implement change, and evaluate the effectiveness and outcomes of actions taken. If nothing else, the Mercer/CAMIMH survey makes clear that it’s time to improve awareness of the impact of mental health in the workplace – especially among top management. For many of Canada’s companies, meeting the mental health challenge may mean seeking out the best assistance in proactively communicating to employees about their mental health, structuring action plans and measuring the results. 

Notes

1. "Nature and Prevalence of Mental Illness in the Workplace". Discussion Paper, Carolyn Dewa et al., Healthcare Papers, Vol. 5 No.2

2. Ipso Reid, Mental Health in the Workplace Study, November 2007