When Nasreen, a 32-year-old marketing manager at a Toronto firm, started to suffer from anxiety and depression related to her isolation during the coronavirus pandemic, her manager and colleagues took notice.

Nasreen, whose name has been changed to protect her privacy, was experiencing increased presenteeism and absenteeism as she suffered from an increasing number of mental-health episodes. She skipped out on virtual social events with colleagues, missed deadlines and the quality of her work declined. While she’d previously shown up to work looking professional, Nasreen began to look more dishevelled on video calls and soon stopped turning on her camera. She also called in sick on days where she had to present, having lost confidence in her work.

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While Nasreen began seeing a therapist during the pandemic, she initially avoided the benefits and employee assistance program available through her employer out of a desire for privacy. It was only after Nasreen’s manager, unaware what she was going though, put her on a performance management plan that she finally turned to her human resources department to discuss her options. Her employer connected her to EHN Canada, which specializes in treating mental health and addiction.

While mental-health professionals were used to seeing employees with mild symptoms pre-pandemic, they’ve seen an increasing demographic of those like Nasreen who are suffering from moderate symptoms, said Lanie Schachter-Snipper, a registered psychotherapist and national director of outpatient services for EHN Canada, during Benefits Canada’s 2021 Mental Health Summit.

People with mild symptoms typically function well at work and their symptoms are only episodic. They’re known as “low touch,” as they may access services and then take a break when they feel ready and can be supported by a range of services, from internet-based cognitive behavioural therapy and self-guided counselling to individual therapy.

However, employees with moderate symptoms experience disruptions both at work and at home. They face increased absenteeism, presenteeism and sick days and their mental health episodes often become more frequent and intense.

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“There are far fewer options for someone like Nasreen, who fits right into this category,” said Schachter-Snipper.

It’s important for employers to have a comprehensive service or package of supports for employees with moderate symptoms to ensure they’re getting their needs met in one program, she added, noting these supports should be easy, seamless and comfortable to access. In addition, she suggested that employers make it clear that they’re private and confidential so employees feel safe seeking them out.

Schachter-Snipper also advised employers to look for providers that can help employees track their progress with data from validated tools and make decisions with their provider based on that data. She emphasized the importance of user experience for any online component, as well as clear communication between the employer, provider and employee, so the employee understands their treatment process.

For employees who are dealing with increased isolation, loneliness, anxiety and depression, it’s important to increase their social interactions with peers, even virtually, she noted. “There are many creative ways to increase connectivity. Many of them are high touch ways so they do require resourcing, but it is worth it because we see better outcomes and it keeps clients engaged.”

In Nasreen’s case, she was identified as likely to benefit from an intensive outpatient program that involved a combination of individual and group therapy, a digital component and holistic features including mindfulness and a physical health practice. She was paired with a provider who specialized in her mental-health needs and had delivery options that matched her desire to stay engaged with work.

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EHN had multiple touch points with Nasreen over the course of her treatment, particularly because she had identified isolation and loneliness as key challenges. It also improved her engagement by using real-time reminders and gamified interactions for her virtual treatment.

Schachter-Snipper also noted group therapy, a key component of Nasreen’s program, has very strong benefits: it focuses on relationships and reduces isolation, as well as reducing stigma by giving participants the ability to relate to others. Half of people with depression experience significant symptom improvement with group therapy.

Nasreen’s journey represents the importance of employer support during an employee’s recovery from mental health and addiction, said Schachter-Snipper. “A really key component was referring Nasreen to the level of care that was most appropriate for her given her presentation.”

Read more coverage of the 2021 Mental Health Summit.