Mental health costs are high, but awareness is low

By Asha Tomlinson
|Canadian HR Reporter|Last Updated: 09/04/2003

When most people hear of an employee taking time off work due to illness, they think of the flu, a broken arm, maybe even a heart attack. But, rarely does one think that person could be suffering from depression or an anxiety attack. Why? Because it’s rather taboo to talk about mental illness in the workplace, according to many mental health experts. It’s an issue that has received little attention and support.

“It’s like a big elephant in the middle of the living room,” says Dr. Pierre Beausejour, chief of staff for the Alberta Mental Health Board (AMHB). “Everybody knows it’s there, everybody sees it, but it’s not discussed and dealt with.”

However, it should be on many employers’ agendas. It’s been estimated that mental illness in the workplace costs nearly 14 per cent of the net annual profits of Canadian companies — that’s as much as $16 billion per year. Studies from AMHB show that mental illness and disability keep more people off work than heart disease, accidents or cancer. It is also predicted that depression will soon be the nation’s leading cause of workplace absenteeism.

“In a couple of years mental health issues in the workplace are going to be the number one issue for disability and loss of productivity in the workplace, it’s an important issue but not recognized enough (by employers),” says Beausejour.

This lack of recognition results in employees hiding the truth from their employers about why they want to take some time off work.

“How many days of sick leave are labelled as, ‘Oh, I had the 24-hour flu’ or ‘I just didn’t feel well,” rather than “I’m stressed out’ or ‘I’m depressed,’” says Beausejour.

Agnes Vandergang, of the Canadian Mental Health Association, says employees are afraid to disclose their mental illness to their employers or even colleagues because of the stigma attached to it. AMHB projects that between 40 and 75 per cent of sufferers don’t seek help for their mental illness because of the shame and stigma of admitting the problem.

“The biggest single barrier is attitudinal,” she says. “We just have so many preconceived notions about what mental illness is and how people with mental illness behave. These notions are powerful enough that even if you had a prior relationship with somebody, once you know they have this label, it becomes very easy to superimpose those ideas.”

Beausejour agrees. To make people more aware, AMHB recently ran an anti-stigma campaign on mental health in the Alberta media.

“One of the (campaign) messages was something like this, ‘It was easy for me to discuss my heart attack with my colleagues...telling them about my depression was a different story.’”

This is why return to work for people with mental illness, once properly diagnosed and treated, can be difficult. Beausejour has heard many of his patients talk about the fears they have of returning back to work after a short- or long-term leave, and many questions arise.

“How do I face my co-workers and employers about this? What do I tell them? What do I keep from them? Are they going to accept me? Is my illness going to effect my advancement in the organization? Am I going to get fired?”

There are cases of discrimination against those who return to work from a mental illness. Some may believe the person is weak or unfit for the job.

Vandergang says most people are afraid of how this person will act once they return to work. They are scared of unpredictable behaviour “and somehow mental illness has become synonymous with unpredictable and even violent behaviour.”

Stories in the media such as the murder-suicide in 1999 at the OC Transpo bus garage in Ottawa has a big impact on the way the general public views people with mental health problems. Pierre Lebrun, a former bus driver, suffered from depression and job-related grievances including being harassed at work because of his stutter, and he shot and killed four co-workers before killing himself. Although these stories are rare, people can get paranoid about a similar incident happening in their workplace. But they should avoid assuming all persons with mental illnesses are violent based on these events, says Craig Pestell, adult support service worker for York Support Services Network.

“People with a mental illness have no higher criminal record than the general population,” he says. “It’s a perception that society bases on media coverage...it’s just a matter of people understanding that it’s not the truth (for all people with mental health problems).”

And the only way to get this message across is by educating, which should start from the top down, says Pestell.

“If people know what clinical depression is and how it occurs in people and why, then they’re less likely to be afraid of it.

“By opening the doors for discussion, you’re going to start understanding why some people are missing days at work and how that can affect their life and your productivity.”

There is a greater amount of information out there for employers, says Vandergang, even in the mainstream media. NBC talk show host Rosie O’Donnell recently dedicated an entire issue of her magazine to depression.

“That’s a great tool. Make things like that available around the office and create discussion.”

But employers must be aware of singling out their employee upon return to work. Each employee should be treated on a case-by-case basis in terms of accommodations and how honest that person wants to be about their situation.

Vandergang says the first thing an employer should do is sit down with the employee, their psychiatrist or EAP service provider — someone who is familiar with the person’s situation and illness, and their supervisor to map out how the employee can gradually move back into the work environment. Part-time work and job sharing are some of the options an employer may consider. But it has to make sense to all parties involved.

Employers must discuss how open the person wants to be about their illness and respect their wishes for privacy, even though Beausejour says honesty is best.

“Usually when there is an employer who is open about supporting their employee who has an illness, it’s usually beneficial for everyone in the overall scheme of things.

“They can meet their colleagues for a coffee break and start breaking the ice that way, discussing with them how they can approach the issue of their return. (People returning to work) can prepare themselves on how they’re going to deal with that and overcome their anxieties and fears towards that.”

Whether it’s return to work from a heart attack or depression, a person needs a period of adjustment, Beausejour says, you can’t start full speed. The return to work should be a step-like approach, slowly reintegrating the worker in to the environment to achieve their full potential.

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