Paula Allen: Mental illness is sometimes a catch-all term. When we talk about mental illness in the workplace, we’re typically talking about depression and anxiety disorders. Those are the most prevalent.
WW: What are the implications of mental illness on the workplace?
Paul Foley: The obvious implications are lost productivity, the impact on the individual and the individual’s impact on others.
Terry Martin: It could also have a negative impact on customer satisfaction—if you’re unable to deliver on service commitments.
PA: If left unaddressed, mental illness can impact the success of a business. Most businesses today demand many cognitive abilities, such as communication and interpersonal skills, which feed into profitability and sustainability. When those are impacted by key people the success of the business is impacted as well.
Wanda McKenna: There are also the challenges of managing performance and productivity when issues of mental illness exist in a work unit. Typically managers don’t know how to respond or talk to an employee [about their mental illness]. We are still battling the stigma attached to mental illness.
Mike Allen: There’s also the safety factor. Yes, we have to deal with that person or try to intervene, but we also have an obligation to protect other employees from harm. We have to be sensitive when we intervene, especially in a situation where there could be conflict. It wouldn’t take much to trigger someone, especially somebody with anxiety. It just needs that little explosive thing inside to get them to that point.
WW: How can managers recognize a mentally ill employee?
PF: Managers have to recognize when there’s a change in behaviour and performance and that something is causing it. Their role is to facilitate and support the employee, and provide the individual with whatever tools and direction are necessary to address the matter—not diagnose the behaviour. The underlying cause isn’t their responsibility.
Tony Fasulo: It’s dangerous to assume front-line managers can recognize and diagnose mental health issues. It’s hard enough for doctors and psychiatrists to diagnose. But it’s important to recognize how the problem is affecting the workplace. Also, many times the cause of an employee’s depression and anxiety is the workplace itself, so it becomes a catch-22. The manager may not see that he or she is part of the problem.
WM: Managers will see a change in performance. When a supervisor has had a long-standing working relationship with an individual, hopefully their first response isn’t to jump into performance management, but rather to have a discussion with the employee, such as “I noticed you are not yourself lately. Is there something going on? Is there something I should be aware of, or can help with?” Hopefully then we’ll find out whether we’re dealing with a health issue or a performance issue. [If it’s the former] we can start the employee down a path of recovery with the right tools and resources.
WW: How can managers support an employee struggling with a mental disorder?
PA: A manager has a need to expect people to perform at a certain level and to protect the interpersonal relationships in a workgroup. If somebody is deteriorating, is unable to perform and it’s impacting co-workers, that needs to be managed. So in a very caring and considerate way, you tell the employee what you’re observing and offer them ways to get support, whether through an employee-family-assistance program (EFAP) or another kind of personal/community support. But you also ask them if there’s anything you can do to help better organize their work. You keep having those conversations. Sometimes a person won’t hear it the first time. Sometimes they might hear it the second or third time, but it’s important they hear it more than once to take it seriously. At the end of the day, the employee has to take care of themselves, but the manager has to continue bringing the issue to their attention.
Fanny Karolev: Within Campbell Canada, we train our managers to recognize the signs of a troubled employee. Our staff tends to know each other well. Should there be evidence of [mental illness], a conversation will take place. Most of the time, that will be followed up with a referral to the onsite occupational health nurse or human resources. The nurse will assess the situation and collaborate with the family physician as far as next steps. If there’s medication involved, being a manufacturing environment, we are concerned for the employee’s safety. Psychotropic drugs, until properly adjusted, are a huge issue. We will give the family physician the employee’s job description, so he or she is aware if the employee works around forklifts and high-speed conveyor systems. The physician can then decide on a suitable treatment plan while the employee continues to work, and perhaps recommend a period off work to allow the medications to be adjusted to the right levels.
We also partner with Shepell•fgi to provide our managers with a number to call to talk about their circumstances with an employee. Our utilization is at 11%. Obviously people are using the service—and with positive results. But it’s the trusting relationship between the employee and the occupational health nurse that makes the biggest difference. She is a critical resource in managing mental health in the workplace because she acts as the hub, communicating with the physician and keeping in contact with the employee regularly.
TF: I agree we need to let doctors know about the employee’s cognitive and physical demands at work. We need assessment tools that we don’t really have to keep people at work. Just because somebody is suffering from anxiety and depression doesn’t mean he or she should be off work for six weeks. In fact, that’s a detriment to the employee. People need to stay in the workplace and be supported. Some doctors don’t know how to assess the situation, so they give the employee the green light to be off work. That’s why we are seeing short-term disability as 30% of all claims. We don’t try to accommodate these employees because we don’t know what they can and cannot do.
Theresa Rose: Based on the research, recovery involves medication coupled with that support network. However, while we’re seeing claims for antidepressants skyrocket on our drug plans and disability rates go up, we’re not seeing that correlation with EFAP utilization or that of the psychology benefit. The two combined tend to have a greater impact.
Shelley Kee: There’s also the issue of compliance and whether the employee actually takes the medication. I think we all recognize that medication in the right case for the right patient is the right course of treatment. But you can have everything line up perfectly—so the employer provides support and encourages the employee to access assistance, and the employee accesses the EFAP program, gets to the doctor and receives medication—but does the person actually take it? Or do they take it until they feel better, think they have kicked the illness, but haven’t necessarily, and then elect to discontinue treatment? So compliance is important. We need to recognize when that person’s prescription is not being renewed and whether it’s because the medication isn’t working, or because the employee has chosen to take himself or herself off it.
WW: How can employers help fight the stigma attached to mental illness?
PF: You make mental health a part of your wellness culture, so you layer it into your health education programs. You send the message that you’re treating the person as a whole so the mental and the physical are linked and can’t be separated—one drives the other.
PA: One of the biggest eye-openers for many people is the fact that there are successful people in leadership positions who, at some point in their lives, have suffered from a mental illness. You can transition in and out and you’re not necessarily marked for life after one episode. That’s helpful for employers [to know] as well when returning people to work.
FK: At Campbell Canada, we discourage phraseology like “stress leave.” You don’t leave work because you are stressed. You leave because you are unable to work. It’s really no different than going off [work] for a hysterectomy. I discourage our management team from focusing on the diagnosis. If you focus on that, subliminally it can put up a glass ceiling over the individual. The manager may think, “Am I giving this person too much stress by promoting them?” Unless the employee is willing to share [his or her diagnosis], there’s no need for management to know.
WM: At McMaster, we monitor our STD claims closely and know that more than 50% of them are attributed to mental health diagnoses. We deal regularly with supervisors who are managing this issue. Some of them are fantastic and supportive, while others are at the other end of the spectrum. They think, “I can pull up my socks and get this done, so why can’t they?” Fortunately I don’t hear that often. We have to appreciate that mental illness represents a significant part of the population—one in five people within their lifetime. We need to realize that these can be episodic issues and that these employees can be productive members of the workforce. Supervisors need more education and awareness about the issue and how they can be more supportive.
Participants:
- Mike Allen, manager, health, safety and emergency, Moosehead Breweries
- Paula Allen, vice-president, health solutions and Shepell•fgi Research Group
- Martin Chung, senior manager, private sector strategy and partnership development, Pfizer Canada
- Tony Fasulo, managing partner, ACCLAIM Ability Management Inc.
- Paul Foley, director, private health plans, Shoppers Drug Mart
- Fanny Karolev, manager, worklife, health and wellness, Campbell Company of Canada
- Shelley Kee, senior director, corporate accounts, Medavie Blue Cross
- Terry Martin, senior product management consultant, group marketing, Sun Life Financial
- Wanda McKenna, director, workplace health, benefits and pensions, McMaster University
- Theresa Rose, director, group product management, Medavie Blue Cross
- Moderator: Nancy Kuyumcu, associate editor, Working Well
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