Guide Summary
Mental health issues are impacting and costing your organization daily. Due to anxiety, presenteeism, and more, employees aren't performing to their fullest for a number of reasons. What can you, an HR leader, do to help? We've developed this Ultimate Guide to get you started. Discover the background on mental health issues, and strategies you can implement to help create and maintain a healthier workplace.
Table of contents
- Introduction
- What is mental health?
- Stress and its physical symptoms
- Mental health in the workplace
- Mental health and stigma
- Mental health and management
- How do you address and treat mental health issues?
- Why telemedicine is an innovative approach to mental health
- Implementing your workplace telemedicine mental health program
- How Canada’s best companies are delivering workplace wellness via Dialogue
The Ultimate Guide to Reducing Workplace Mental Health Issues In Canada
Canadian adults spend more of their time at work than anywhere else in their lives1, so what happens there can have a significant impact on their mental health. The joys and rewards of a “win” or teamwork can give people self-worth and happiness, but sometimes too many stressors accumulate or problems outside of work negatively impact employees. That’s why it’s crucial to not only support the physical health and safety of your workforce, but also, mental health has to be a priority.
Mental and physical health are intertwined, and physical challenges or ailments can trigger disorders like anxiety and depression, and vice versa. People with a serious mental illness are at a higher risk of developing a chronic physical health condition, and Canadians with a chronic physical illness experience depression and anxiety twice as much as those who aren’t chronically ill, according to the Canadian Mental Health Association.2
Moreover, the costs are high when mental illness is left untreated. The total cost to the economy is estimated to exceed $50 billion each year. When it comes to productivity alone, Canadian employers lose more than $6 billion annually due to absences and turnover because of employee mental health issues.3 It is thus very important that mental health care be a part of a holistic approach to corporate wellness.
What is mental health?
According to the World Health Organization, “Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
These problems can take a lot of different forms, such as anxiety and depression, which are the most common disorders in Canada, as well as other disorders such as eating disorders, psychosis and even suicidality.
The roots of mental illness are complex and caused by a combination of factors like the external environment and genetics. But no matter the causes, a workplace approach to mental health can have a big impact on the results employees see.
Stress, anxiety and depression are statistically the most common mental health complaints. World Health Organization (WHO) data confirms that major depressive disorder (MDD) is the leading cause of disability worldwide.5
Stress and its physical symptoms
Stress is important to recognize and manage as it often leads to unpleasant, and sometimes chronic, physical symptoms, such as:
- headaches
- muscle tension and pain, chest pain
- shortness of breath and chest pain
- increased heart rate and higher blood pressure
- a weakened immune system
- fatigue and insomnia
- stomach and digestive problems
- high blood sugar
- increased cholesterol and fatty acids6
Stress can also make people more forgetful, or cause anxiety, restlessness, irritability, defensiveness, mood swings, sensitivity, and anger. It can make it harder to make good decisions, focus on tasks, think clearly and be productive.
Chronic stress has been reported to be associated with health conditions like:
- anxiety
- insomnia
- muscle pain
- high blood pressure
- weakened immune system
- heart disease
- depression
- obesity
On average, 2% of the Canadian workforce is on disability for a mental health issue.
Based on research conducted in a virtual clinic setting, the cost of all disability and presenteeism is estimated at $150 per employee per month.7
Even when an employer manages to create a stellar working culture enforcing values everyone is proud of, employee mental health can still be impacted by problems in the workplace or at home, such as heavy workload, perception of work-life disbalance, or a tense relationship with one’s manager.
Some key statistics to highlight:
- Nearly half of working Canadians—a whopping 47%—agree that their “work and place of work are the most stressful part of their day and life.”
- More than a quarter of Canadian employees consider their work-related stress to be high.8
- About 30% of short-term and long-term disability claims and 70% of disability payments in Canada stem from mental health issues.9
- The Conference Board of Canada estimates that depression, chronic depression, bipolar disorder, social anxiety disorder, panic disorder, and agoraphobia currently cost the Canadian economy $20.7 billion a year. This cost is expected to increase to $29.1 billion by 2030.10
But when mental health is supported, the number of absences, grievances, medical leaves, and disability claims can be reduced.
When people have a mental health condition but don’t call in sick, which is also known as presenteeism, it can bog down productivity. An American study by the Employers’ Health Coalition found that workers who were ill but present at work were 7.5 times less productive than those who called in sick and ultimately recovered more quickly.11
In a 2012 report, the Sun Life Wellness Institute and the Richard Ivey School of Business measured the return on investment of employee wellness programs at a savings of 1.5 to 1.7 absentee days per employee, or $251 to $274 per year, per employee.12
- 64% of Ontario workers said they would be concerned about how work would be affected if a colleague had a mental illness.
- 39% of Ontario workers surveyed said that they would not tell their managers if they were experiencing a mental health problem.
- 40% of respondents to a 2016 survey said they had never sought medical help for feelings of depression and anxiety.13
As a result, those suffering may feel ashamed, embarrassed, or experience a drop in self-esteem, and these could exacerbate the issues further.
Mental health and management
Managers play a major role in supporting employee mental health. However, managers can also be grappling with more stressors from taking on additional responsibility, making them even more susceptible to mental health issues.
Managers are too often seen as the cause of stress at work, and in fact, they report higher rates of depression and anxiety than those at the C-suite top or entry-level positions, according to researchers at Columbia University. Almost double the number of supervisors and managers reported they suffered from anxiety compared to workers, and 18% of supervisors reported symptoms of depression compared to 12% for workers.14
But why are managers more at risk? Researchers suggest managers tend to have more responsibility but less power to make decisions—meaning they’re feeling stressors from both the top and bottom of the corporate hierarchy. A manager with a mental health issue could be confronted with the same problems as a worker, but the impact is far greater because of how it affects the rest of the team.
How do you address and treat mental health issues?
It can seem like a daunting task to develop a game plan for helping your employees address such a wide range of mental health symptoms and root causes. But the good news is that there are many effective services you can connect your employees to, and when you make it easy for them to opt in, the positive results are undeniable. Here are some ideas to get you started.
Develop a mental health program
A good mental wellness program is one that is easily accessible and utilized by employees, and one that acknowledges the mental health of the workforce. Your employees will feel better coming to work in an environment where stress is manageable and services are available.
Workplace mental health programs can help create “psychologically healthy workplaces”, which will make for15:
- A higher quality of employee engagement
- Better overall morale in the workplace
- Higher levels of employee satisfaction
- Higher retention rates and more attractive recruitment positioning
- A more productive organization
We’ve already seen how much money there is to be saved in reducing disability claims, absences, and presenteeism, and that’s just the tip of the iceberg. It can be difficult to quantify the potential revenue gains that come from building a culture of wellness at work, because the effects of having a happier, more engaged workforce compound positively to influence everything from attracting the best talent to making optimal decisions.
One thing is for sure, though, the first benefit a mental health program provides is a chance to break the cycle of silence and stigma around mental health in the workplace. Major Canadian companies like Bell have created massively successful awareness campaigns, like Bell Let’s Talk Day, which aim to reduce the stigma associated with mental illness by encouraging people to talk openly about their own challenges. It’s also possible to implement initiatives on a smaller scale to benefit from incremental organizational changes in behavior and perception.
What makes these programs successful is a top-down commitment to being open about and encouraging of mental health care. If employees feel encouraged to access their mental health benefits, the greatest benefit will be the ability to acknowledge and seek help for symptoms before a problem escalates. And taking a preventative approach to treating mental health issues may reduce disability-related costs in the long run.
Build a mental health toolbox
There are several resources available for organizations and managers in particular to use to create a healthier environment. The Mental Health Commission of Canada provides standards and guidelines for workplace mental health, as well as training courses like Mental Health First Aid.
There are plenty of tools available at your fingertips. Here are a few ideas to get you started.
Psychotherapy
Psychotherapists are often less expensive than psychologists, but can provide some similar approaches such as the well-researched and highly beneficial Cognitive Behavioural Therapy (CBT). Providing employees with insurance benefits that cover the costs of psychotherapists can provide employees with an important outlet while reducing the financial burden for seeking help.
Employee Assistance Program
These programs help employees navigate interpersonal issues or stressors that aren’t necessarily directly related to workplace challenges. It just makes sense to assist employees with anything that could prevent or harm job performance in the future.
Healthy Break Activities16
From meditation sessions to cleaning up communal areas or planning a healthy meal together, there are plenty of ways to help employees take breaks from work that will help them relax, energize, or re-focus. Research the types of healthy break activities that are best suited to your team and see for yourself!
Create a workplace culture with values you’re proud of
From ensuring employees are taking valuable breaks or using vacation time, or encouraging honest feedback and gauging employee sentiment and overall well-being with software like OfficeVibe, management needs to lead and be held accountable for workplace culture.
Train managers on mental health strategies
Make sure managers know how to access health services and train them on how to identify issues that could potentially snowball into larger issues. More than anything, you want your managers to be active promoters of your company’s mental health benefits:
- Ensure they’re aware of common mental health issues
- Train them on how to help teams recognize when they might need help and know how to communicate with employees about the services available to them.
- Make sure managers receive comprehensive guidance on how to screen for behavioural issues and stressors and are aware of how their management style affects their team.
- Have them ensure their teams understand what health benefits they’re entitled to. A recent study showed that 58% of employees don’t know what their benefits package offers or how to access those benefits.17 If people aren’t aware of services, then they won’t seek them out.
Encouraging employees to talk about their mental health concerns both increases trust between managers and employees and facilitates an open, judgment-free conversation. By maintaining an open conversation, managers can encourage employees to speak up when in need, and even help prevent mental health issues from arising in the first place.
Promote healthy living
Exercise, nutrition, meditation, sleep quality, therapy or life-coaching—these are all healthy activities that can help employees feel good and stay on top of their game. Promote these types of activities as part of team-building exercises or social gatherings to introduce or reinforce healthy living. Not ready for a group nap? Try starting a conversation on Slack about hacks to improve sleep or share the latest apps that can help with healthy meal planning.
Why telemedicine is an innovative approach to mental health
When one is sick, one seeks a healthcare professional to get advice. However, because of the ongoing stigma related to mental health issues, many people still feel uncomfortable having frank discussions about it with others. And without easy access to support, they may delay seeking help until problems escalate.
Telemedicine works to overcome that barrier, to make it easier to prevent and treat all types of health issues in the workplace. Rather than travelling to see a professional in person, telemedicine—using online chat, video or voice calls to communicate—is an increasingly popular way for people to efficiently and conveniently access the help they need without the fear of judgment.
Telemedicine has been widely adopted in the UK and the USA, but just 9% of Canadian workplaces are connecting their employees to virtual healthcare programs.18 Companies like National Bank of Canada, Lightspeed, and Ubisoft have taken the leap by offering telemedicine to their workforce and are reporting success, largely due to the ability to fit healthcare into otherwise busy schedules in what would normally be “after hours”. Who wants to wait around in a doctor’s office waiting room or a hospital emergency room anyway?
In the context of mental health, preventing stressors from creating chronic problems is a major benefit of the telemedicine model—connecting employees to solid guidance on stress management is just a matter of logging into an app.
By making mental health resources available in a private, time-flexible space such as telemedicine, employees will find it easier to seek help as symptoms start to arise.
Telemedicine makes it easy to provide employees with preventative care right when and where they need it, rather than only becoming available after mental health issues have developed or worsened.
Many healthcare providers believe a multidisciplinary approach, or collaborative care, is the “future of medicine.”19 This is a holistic approach that demonstrates how body and mind are linked by encouraging various healthcare professionals (e.g. case manager, mental health coach trained in social work, nurse, general practitioner) to communicate with one another to ensure the patient is receiving the best possible care.
Telemedicine isn’t the right solution for every case—for severe psychological distress, for example, an in-person treatment program is recommended. But online treatments such as videos with a therapist, iCBT modules and medical follow ups when medication is needed, can be effective—sometimes even more effective than in-person consultations, according to a 2008 study.20 Many types of patients, particularly when there is adherence to treatment and follow-up appointments, might benefit from a virtual care approach.
There is also a growing market for mental health and mindfulness apps. These often include guided meditations and advice on recognizing symptoms of stress and developing better coping mechanisms. The Canadian Institute of Natural and Integrative Medicine has seen award-winning results with its BreathingRoom app, which is made available to adolescents and young adults in Canada through partnerships with various educational, governmental, and service organizations.
Patient journey and scope of practice
The most effective workplace programs are those designed to holistically meet the needs of employees. 85% of individuals who are diagnosed with major depression have at least one other additional serious medical condition, and 30% have four or more conditions.21 By providing patients with easy and convenient access for physical symptoms, mental health issues can be identified proactively through screening tools. They can then be addressed rapidly with a personalized approach, wellness resources, CBT psychotherapy, and more. Close follow-ups with a trusted person is key to ensure patient outcomes are positive. Developing a trust relationship with the care provider is essential for the patient to open up and be able to work on himself. For this to happen, the care should be coordinated by the same person throughout the duration of the care.
Precisely measure success
Crucial information about how your workforce is accessing mental health services through telemedicine can easily be aggregated and collated to help you adjust offerings and ensure your mental health wellness toolbox is relevant, useful, and delivering a high return on investment.
Enhanced privacy and patient confidentiality
Many patients find it embarrassing to go to their doctor’s office for a mental health problem because it can reveal their distress to others who know about the appointment. But when the connection to a health professional can be from any location, and without the need to spend time travelling to a distant location, care becomes much more discrete. That helps break down a barrier to seeking help.
Ensuring patient confidentiality is crucial—if people can’t trust their employee program to maintain privacy, they simply won’t use it.
Telemedicine can be an opportunity and a challenge. How will you protect individuals and make sure that employees confidential health information isn’t inadvertently shared with third-parties? You’ll need to work with trusted companies with expertise, certifications (SOC 2 for example) and established processes in protecting privacy who can demonstrate how they’ll stay ahead of the curve.
You’ll also want to brush up on healthcare legislation. In Canada, privacy laws fall under provincial jurisdictions, so you’ll want to look at Ontario’s Personal Health Information Protection Act (PHIPA), for example, to ensure that the telemedicine wellness program of your dreams complies with provincial laws.
While building trust and encouraging employee engagement should be your top priority, don’t let that discourage you from building the quantitative and qualitative reporting and metrics you need to demonstrate the business impact the program is having. As long as you are using aggregated, anonymized data, you can still get a clear picture of your return on investment in your workplace mental health program without jeopardizing employee privacy.
Cost-effectiveness
Compared to the high cost of traditional therapy, virtual care can be considerably more affordable. Furthermore, with the proactive approach of a holistic solution that addresses physical and mental health issues, the objective is to minimize mental health-related costs like short-term disability and long-term disability.
Convenience
Several barriers to care or treatment (limited access to healthcare resources, time off work required, time to travel and wait for appointment, feelings of shame) are easily eliminated through a more convenient and integrated solution like virtual care. When an employee is unwell, potentially even unable to get out of bed in the morning, having a seamless option accessed from the convenience of their own home can help increase the chances of seeking help and the efficiency of the delivery of care, maintain patient engagement, and encourage adherence to treatment.
How to implement your workplace telemedicine mental health program
As most HR professionals already know, you’ll have to make sure all employees are aware of your workplace telemedicine mental health program, have access to assistance when signing up, and are trained on how to use it effectively and safely before implementation. This may involve email campaigns, posters, and many reminders—but it’ll be worth it when it comes to encouraging adoption, adhering to treatment plans, and preventing issues in the workplace.
You’ll also have to clearly define how telemedicine will fit into your current workplace benefits. Identifying a virtual care provider who can assist with all these points is critical to ensuring a successful utilization level of the service.
Hopper, a travel app company based in Montreal, had to quickly implement a corporate wellness program for employees after scaling up to more than 200 people.
They chose Dialogue after hearing about it from several employees, and report that the wellness program is perfect to empower employees to be proactive about their health and well-being, anytime and anywhere in Canada. The management team also feels that having Dialogue as a resource facilitates otherwise challenging conversations with team members who may need support.
SSQ Insurance, a leader in group insurance, offers access to Dialogue’s Stress Management and Well-Being program to all its 2000+ employees across Canada because the “organization continually seeks to provide relevant tools and deploy innovative solutions that will contribute to the well-being of our policyholders,'' says Éric Trudel, Senior Vice-President of Strategy and Product Management.
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2. https://ontario.cmha.ca/documents/the-relationship-between-mental-health-mental-illness-and-chronic-physical-conditions/
3. https://www.mentalhealthcommission.ca/English/what-we-do/workplace
4. https://cmha.ca/about-cmha/fast-facts-about-mental-illness
5. WHO. Depression and other common mental disorders: global health estimates. Geneva: World Health Organization; 2017. p.17.
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7.
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19. http://www.shared-care.ca/
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