Posted by Dr. Mark Dermer on November 19, 2018
Dr. Mark Dermer

Canadian employers face growing costs related to illness, absence and disability. Among the reasons why employees miss work, mental health issues continue to cause the greatest number of lost days. Figures from Health Canada and the Mental Health Commission of Canada are staggering:

  • 1 in 5 Canadians experience a mental health problem or illness in any given year
  • In any given week, 500,000 Canadians miss work due to their mental health
  • Mental health problems cost the Canadian economy over $50 billion per year

Employer costs aren’t limited to worker absence; “presenteeism”, or working when unwell, creates a significant portion of productivity lost to mental health problems. Data tell us that for every employee who is off work due to their mental health, 10 others are on the job but working below their potential due to ongoing mental health problems. Though some of these workers will be receiving treatment, others will have not recognized the problem or not sought help. That makes it a priority to identify those who need help since early treatment leads to better outcomes, which benefits both the employee and the employer. It’s a true win-win.

Unfortunately, employers struggle to find ways to meaningfully assist their employees. Part of the challenge is the stigma attached to mental health, which makes employees reluctant to disclose their problems, especially to their employers. But even when employees are forthcoming, or the problem is obvious, employers still have difficulty meeting their employees’ needs. The current approach relies primarily on Employee Assistance Plans (EAPs), which provide short-term counselling to help overcome a person’s current challenges. But the current approach suffers from several shortcomings:

  • Reactive – there is no attempt at early detection.
  • Incomplete – other than counselling, traditional EAPs usually don’t provide any resources. That’s particularly hard on patients without a regular doctor, since they lack access to a provider who can assess them and prescribe medications for them when indicated.
  • Fragmented – available resources are distributed among several points of contact and generally without any person coordinating care for the patient. That can lead to delays and miscommunications that cause harm and slow recovery.

The second and third shortcomings are eventually overcome if an employee ends up on long-term disability (LTD). In such circumstances, the insurer is highly motivated to limit the duration of the claim, so they use a “case management” approach, where one professional coordinates the patient’s treatment and recovery. However, LTD coverage begins three months or longer after the employee first leaves work, losing valuable time to treat more comprehensively. And while LTD provides the employee with income replacement, it does not compensate the employer for lost productivity.

But what if employers had a solution that addresses these problems and more? One that:

  • Screens to enable early detection of mental health problems
  • Provides evidence-based resources for employees to self-manage their stress
  • Introduces a multidisciplinary care team with case management as soon as a mental health issue is identified
  • Delivers virtual services that eliminate travel and wait time to see health professionals, via the patient's choice of chat, phone or video consultation
  • Follows-up regularly to increase patient engagement and adherence to the treatment plan

And what if the solution could be offered at low cost and with a high ROI?

Until now, a solution with these features would be unattainable. But a comprehensive telemedicine program offers the opportunity to achieve things that we couldn’t in the past.

Telemedicine can reduce the cost of productivity lost to employee mental health problems because it allows professionals to more efficiently deliver services to the patient. Using a computer or portable phone, the employee can discretely take a brief screening test. They can then quickly connect to a team of nurses, psychologists and physicians who collaborate and coordinate the patient’s care at convenient times, and regularly check in with the employee to follow-up and adjust the treatment plan accordingly.

This approach can not only reduce the time to recovery and return to productivity, but it also eliminates the multiple hours lost to travel and waiting for each in-person appointment with a doctor or psychologist. Abundant research demonstrates that face-to-face video consultations with a continuing and compatible therapist achieve outcomes similar to conventional office encounters for mental health. And evidence also suggests that patients miss fewer appointments and remain more engaged with telemedicine mental health services.

Employers can expect to see an increasing number of offerings for telemedicine mental health solutions from benefits providers. Employers who scrutinize these opportunities should look for comprehensive and flexible programs with personalized treatment that demonstrably improve employee health and thereby reduce absenteeism. By helping both employees and their employers, such programs offer a very compelling value proposition.


Contact us to learn how you can implement Dialogue to improve your employees' well-being.


Topics: For Organizations

About the author

Dr. Mark Dermer is a telemedicine physician. He has extensive clinical, leadership, consulting and innovation experience in a broad range of healthcare environments. Dr. Dermer is a graduate of McGill University.